April 3, 2000

BIRMINGHAM, AL — Birmingham's Regional Trauma System (BRTS) acted effectively to reduce injury and death following the F5 tornado that struck the area on April 8, 1998. Results of a study detailing the system's response are reported in the April issue of The Journal of Trauma: Injury, Infection and Critical Care.

The study — the first of its kind — found that the system was "very effective" in identifying and transporting victims to the most appropriate medical facilities. "Given the impact of tornadoes in this country, particularly in this state, an understanding of the area's ability to respond to such disasters is paramount," says Gerald McGwin, Ph.D., assistant professor of epidemiology at UAB.

The Birmingham trauma system, the only one of its kind in the world, allows for real-time communications between emergency medical services (EMS) personnel in the field and 10 area hospitals. "Victims are taken to whatever facility is best equipped to provide treatment for their injuries," says McGwin. "Level one hospitals are not overloaded with less serious cases, and more serious cases are not taken to hospitals not prepared to treat them."

Getting victims to the right facility may mean the difference between life and death. "Other studies have shown that 20 percent of trauma deaths could have been prevented if surgical care had not been delayed," says McGwin. "Thus, delays in transport to the appropriate facilities may be an important factor in the outcomes of patients injured in tornadoes and other natural disasters."

The study, conducted by the UAB Center for Injury Sciences and the UAB Injury Control Research Center, evaluated 224 patients treated at nine area hospitals after the tornado. Thirty victims were pronounced dead at the scene. Two died later at level-one trauma centers from severe head injuries.

"The tornado was a test of the trauma system, and we believe it did very well in helping to save lives during a worst case scenario," says McGwin. "The study also demonstrates to the trauma industry the need for organized trauma systems with integrated real-time communication systems, like Birmingham's."

Evaluation of the BTRS response also led to changes in the way the city prepares for disaster. On the night of April 8, workers encountered communications obstacles when their battery power proved to be inadequate. Additionally, a shortage of supplies and immobilization devices hindered the ability to transport patients. Today, mobile "disaster trailers" containing supplies and power sources have been placed at various EMS locations in the region.

Each year, an average of 800 tornadoes are reported in the U.S., resulting in approximately 80 deaths and more than 1,500 injuries.