With tornado sirens filling the air in Kalamazoo County on the evening of May 7, 2024, several emergency medicine/EMS physicians at Western Michigan University Homer Stryker M.D. School of Medicine (WMed) quickly jumped into action at multiple locations, including a local mobile home park impacted by the natural disaster.
The response was part of a unique relationship with the Kalamazoo County Medical Control Authority (KCMCA), the agency responsible for coordinating and overseeing the county’s EMS system and housed within WMed’s Division of EMS and Disaster Medicine.
An EF-2 tornado touched down just before 6 p.m. on May 7 near the intersection of South 10th Street and West R Avenue in Texas Township, traveling northeast for roughly 11 miles through the city of Portage before ultimately lifting north of East N Avenue near 31st Street in Comstock Township, according to the National Weather Service. The tornado reached estimated peak wind speeds of 135 miles per hour during its 22 minutes on the ground, severely damaging many homes, businesses and two mobile home parks – Oak Brook Estates and Pavilion Estates.
“Fortunately, really fortunately, and still amazing to this day, is that there were very few injuries and no deaths,” said John D. Hoyle, Jr., MD, the David T. Overton Endowed Chair of Emergency Medicine at WMed and an Associate EMS Medical Director for KCMCA. “Had there been entrapped patients or serious injuries, we have four board-certified physicians who have specialized training for dealing with that exact thing, which is not common to find in a county this small. If we had to get in under the rubble with patients and do direct care for them, we could do that.”
Dr. Hoyle was at home when he first heard the tornado sirens. Using an app on his phone, he began monitoring 911 calls in the county and it quickly became apparent Pavilion Estates had been hit hard by the tornado. Eager to help, Dr. Hoyle and his wife, an emergency medicine nurse practitioner, retrieved one of WMed’s three physician response vehicles, MSU-2, and headed toward Pavilion Estates.
William Fales, MD, professor in the Department of Emergency Medicine, division chief for the Division of EMS and Disaster Medicine at WMed, and EMS medical director for KCMCA, was alerted with the initial 911 calls reporting multiple structural collapses in Portage and a direct hit to the Pavilion Estates mobile home park east of Portage. Based on the preliminary information, Dr. Fales declared a Level 3 mass casualty incident alerting Kalamazoo hospitals and triggering Life EMS to provide at least 20 additional ambulances.
Also responding was Joshua Mastenbrook, MD, associate professor and EMS Fellowship Program Director in the Department of Emergency Medicine, Associate Medical Director for KCMCA, and firefighter/medical officer for the Richland Township Fire Department. Dr. Mastenbrook responded with Richland Township Fire Department to the mobile home park.
“There are not a lot of places in the country that would have a handful of board-certified EMS physicians readily available,” Dr. Mastenbrook said. “It’s also unique that we have several dedicated EMS physician response vehicles that we can take out into the field that are equipped with cardiac monitors, trauma supplies, and other medical supplies.”
WMed is one of only two emergency medicine residency programs in the United States that has a longitudinal EMS curriculum with a resident physician EMS response vehicle. The 24/7 resident-staffed medical support unit (MSU-1) responds to a variety of EMS incidents every day throughout Kalamazoo County. MSU-1 is dispatched to all cardiac arrests, vehicle crashes with entrapment, building collapses, water rescues, multi-casualty incidents, major hazardous materials incidents, multi-alarm fires and other similar high-profile incidents in Kalamazoo County. Emergency Medicine residents and EMS fellows receive extensive training in EMS, triage, and disaster medicine.
Emergency Medicine resident Michael Brancato, MD, was assigned to MSU-1 the day of the tornado and responded to both the city of Portage and Pavilion Estates. Upon arrival to a scene of multiple residential homes that had been badly damaged in Portage, Dr. Brancato was directed to a woman in active labor, accompanying her in the ambulance to the hospital where she delivered shortly after arrival. He then joined Dr. Fales at Pavilion Estates.
EMS Fellow Steve Godfrey, MD, also responded in MSU-2 to the FedEx complex in Portage where a roof collapsed and reportedly trapped 40 workers. Fortunately, the workers were all able to escape without serious injuries. Dr. Godfrey was later assigned to one of the shelters to provide further assessment of people needing emergency sheltering, many of whom had chronic medical conditions.
“EMS physicians bring an additional skill set in terms of procedures that can be done,” Dr. Hoyle said. “They have specialized airway equipment to help intubate, as well as drugs that will help facilitate that. They also have an ultrasound machine, they can quickly do an ultrasound that will look for bleeding in the abdomen, bleeding in the chest, a collapsed lung, and all those things help ... That's typically stuff that doesn't get done until you get to the emergency department.”
At Pavilion Estates, roughly five to 10 people were being treated for minor injuries. Dr. Fales joined Kalamazoo County Sheriff Rick Fuller and Comstock Fire Chief Matt Beauchamp at the unified incident command post at the mobile home park. Complicating things further was a report of a second tornado approaching the scene which ultimately passed less than a mile to the north without ever touching down. Drs. Brancato and Hoyle were staged at the trailer park but fortunately their services were not needed.
While WMed/KCMCA EMS physicians were in the field, KCMCA administrative staff Craig Dieringer and Michael Bentley, both experienced paramedics and WMed employees assigned full-time to KCMCA, responded to the city of Portage emergency coordination center and the Kalamazoo County emergency operation center, respectively. There, they worked with emergency management, EMS, and other public safety leaders to assure adequate EMS resources were staged in the county to respond to any additional tornado-related casualties and to assure that regular 911 EMS calls were handled in a timely manner. Within one hour of the tornado striking, 25 ambulances from Life EMS and from EMS agencies around the region were in place, if needed.
“We were prepared to find many, many victims and the fact that we didn't was truly a miracle,” Dr. Hoyle said. “The other fortunate thing is that, had it been really bad, we had multiple well-trained EMS doctors on scene pretty quickly.”