The medical impact of tornadoes in North America

North America suffers some of the most severe tornado disasters of any loca tion on the planet. Significant injury and economic impact may result from these storms, particularly in rural areas. Tornadic storms present unique p roblems for prehospital and Emergency Department personnel. Soft tissue inj uries seen after tornadoes are contaminated with polymicrobial flora and ma y require delayed primary closure. Fractures are a frequent cause of hospit al admission and head injury is a frequent cause of death. Advanced. warnin g and proper sheltering actions by a population a:re the most significant f actors in reducing morbidity and mortality. This article reviews the pertin ent literature on the medical impact of tornadoes and details the mechanism s of injury, nature of injuries, prehospital and ED planning points associa ted with tornadic storms. (C) 1999 Elsevier Science Inc.