Do you know the most common injuries your character could suffer during a tornado? What are the five categories of triage? What are the signs of internal bleeding? What did I try to pierce with a rock? Find out on this episode.
Welcome to the last of this three-part tornado series. Week one was Tornados 101, where I covered how tornados are formed and the signs of potential tornados. Week two was Inside a Tornado (Survival), where I covered what happens when a tornado hits and how to give your character the best chance of survival. This week, we are talking about what your character will do if they are injured or need to help someone injured in a tornado.
Before we get started today, let me be very clear: I am in no way, shape, form, or fashion a medical person of any kind. This is not medical advice! This is solely for the purposes of writing fiction stories and nothing else!
Now, let’s get into this.
In a tornado, there is a high chance of inquiry. I will cover many of the common injuries, but this is by no means a full list, only a good starting place.
Let’s start by listing them out and then going over them. In a tornado, there can be
* Cuts, scraps or lacerations
* Bruises
* Broken or fractured bones
* Dislocations
* Crushing injuries
* Irritation to eyes, ears, nose, or airways from dust and debris
* Strained or sprained muscles
* Foreign bodies inside the body from debris
* Head trauma
* Brain injury
* Internal bleeding
* Back or Spine injury
* Amputations
* Or even death
A few other things, the low pressure associated with some tornados is believed to have caused pregnant women close to their due date to go into labor. Heart attacks can happen from the stress and fear of going through a tornado. People witnessing or driving close to a tornado could end up in a car wreck. Infections in the days after injuries are always possible; historically, infections were the number one cause of death in many instances.
Potentially, hypothermia is something your characters might have to face if their shelter is destroyed. In modern stories, heat is something your character must deal with if there is no AC. I already have a full episode on heat-related illnesses and hypothermia. Plus, there are several episodes on what to do to stay cool without AC and how to stay warm without electricity, so I will not be covering those today. If you want to know more, you can find my episodes on all podcasting platforms and YouTube.
Now, let’s break some of this down. Eyes, ears, nose, and airways can be affected by the dust and debris in the tornado. When we were hit with a tornado, it only took the shingles off our home, while it did take out the barn. The pollen and dust were thick in the air and caused some of the worst hay fever (what we call allergies) we had ever had. Several of us had sinus infections afterward. However, in the EF5 I spoke of last week, one story was of a demolished home, and the person physically looked a different color because of how much dust and dirt they were covered in. I met them the following day after they had a good shower, and their eyes still looked black where they should have been white. The severity of dust and debris in the air will depend on the severity of the tornado.
Cuts and scrapes are fairly well known to deal with. Larger lacerations might require stitches. Your character will need to apply pressure to the area until they can receive stitches. Hopefully, they do not have to do this alone in the wilderness in caveman times, but I’m sure someone did. If possible, they should use a clean cloth or leather to place over it to hold pressure. There are certain types of leaves that do well with this. Plantain leaves work well and also have anti-inflammatory and antibiotic properties.
Historically, needles have been made of thorns from trees, such as hawthorn trees, from bones, wood, porcupine quills, and more. Stitches in history have been made of cotton, silk, hemp, and even pig or cat intestines. I wish I was making that up, and no, I don’t want to know who thought of that or why.
Dislocations can be painful, but I have found most are more painful after they are back in the correct position. I don’t know why. They can have long-term impacts on your character’s joints, muscles, and mobility. Many people who dislocate their shoulder will later have shoulder pain. I dislocated a thumb, and it be stiff, it can lock up, or even painful.
They will need to be “set.” That means they are placed back into the socket they belong in. This most often requires a second person’s help, or like you see in the movies, ramming it into something and hoping for the best. However, that could tear muscle and make everything worse.
Foreign bodies inside the body can be anything from splinters and stepping on nails or glass in the aftermath to being impaled with something. Modern first aid for anything bigger than a splinter is to leave it where it is in the body. Removing it could have unintended consequences, such as bleeding out if hit in an artery. That is why you should secure it to the area and transfer the patient to the nearest medical facility. This could mean that if they have a screwdriver in their neck, it is wrapped as carefully as possible, and they are transported in the back of a pickup truck to the hospital. Don’t strangle the poor character, they have been through enough.
If writing historical, your character might need to stop the bleeding quickly. If they are not a doctor, the fastest way most societies stopped it was to burn everything in the area where the blood was coming from to try and stop the bleeding. Not recommended in real life. It sounds painful, and many will faint. That said, you will find some people are just another kind of tough and grit their teeth but never make a sound. It is not always predictable who will do which.
There is the chance of electrocution from downed power lines. Characters will need to be careful to watch out for this in any modern story.
For broken bones, in modern stories, try to wrap them carefully with something to support the area and keep it as unmoved as possible until they can get medical treatment. In history, the bones could be set by almost anyone with the strength to set them. They would then wrap them tightly on a straight support, such as several sticks around the arm or leg. They needed to make sure they could not move the body part for weeks to give the bone time to heal. This could mean using crutches or putting an arm in a sling. Fractures are set like this also.
Body parts can be amputated in some instances. Remember that bleeding will need to be stopped. If your character is using a tourniquet, remember they have to place it on the upper arm or the thigh of the leg. The lower arm and the calf of the leg both have two bones, with blood vessels between them. You can’t entirely stop the bleeding if your character’s tourniquet is there. Also, many times in history, they just flushed the wound, cauterized the blood vessels, and sewed them up, hoping for the best. Modern stories could hold exceptions where they can reattach the limb if it is in good enough condition. That might be a big if in a tornado.
Crushing injuries can be more complicated, but they don’t have to be. They could be crushed by a wall or other large debris. This could be the whole character, likely killing them. Crushing to the chest is also likely to kill, even in modern times. A single body part could be crushed also: arm, leg, hand, foot, etc.
I can tell you this can feel different for each character and on each part of the body. An example is that I once had my hand crushed after an old farmhouse window with counterweights had the weight break, and the window fell, crushing my hand. It hurt a lot! My hand swelled three times bigger than it was and was black and purple for weeks. Somehow, nothing was broken. However, I was once hit in the face with a rock. I attempted to pierce the bridge of my nose the hard way. It didn’t hurt. It felt like I was poked in a bruise, but it didn’t hurt. I likely should have gotten stickers for that one, but it’s too late now.
Internal bleeding that you can’t see is likely as tricky to write, as it is also tricky to detect if you are not a medical professional. Signs and symptoms could include
* Swollen or tight stomach
* Extended abdomen
* Nausea or vomiting
* Pale, clammy, sweaty skin
* Breathlessness
* Headache
* Dizziness
* Can’t remember the tornado (event where they were injured)
* Confusion
* Altered state of mind
* Head wound
If writing modern, they need to get to the nearest medical center right away. This is always considered a life-threatening injury.
If writing historical, there was not a whole lot they could do. Some cultures, such as the Egyptians, practiced drilling a hole in the skull to relieve the pressure on the brain. In medieval Europe, they practiced bloodletting. They would cut into a vein or artery to remove blood from the victim. This would likely kill them unless they were lucky enough to hit the injury instead. This is almost a guaranteed death. I won’t say 100%, but it is sure close.
There is also a good chance your character was not wearing shoes when the tornado hit, although some people in modern times will put shoes on when tornado watches come out, just in case. If they do not, or maybe they were sleeping, they might be walking barefoot on debris afterward. This could be glass, nails, sewing needles, etc.
As I said, infections in history, and I imagine after the apocalypse, were a high risk. One thing that combated that was colloidal silver. It sounds crazy, but it has been used since the Romans, and I know people today who still swear by it. A silver coin in the bottom of a cup is a historical variation of this. Remember that most coins made after 1964 contain little or no sliver. The plantain plant is something that is and has been used for hundreds of years. It can be used as tea, or the leaves used to apply it to the cut that is infected. Better yet, before it is infected, to try and ward off infection before it happens. Of course, in a modern story, depending on what happens in your apocalypse, there could be modern or advanced antibiotics.
With infections come fevers. Today, we have over-the-counter medications to help. Historically, tea was used to help bring the fever down. Some things used were licorice root, yarrow, bayberry, fennel, catnip, lime blossom, chamomile, lemon balm, ginger, and elderberries.
Now, in very serious scenarios, triage will be needed if large numbers of people are injured. Triage is just a fancy way of saying determining who needs help first because they are the most severely injured or have life-threatening injuries and who can wait longer. The very sad reality is that if there are large numbers of severely injured people, hard decisions on who to save might have to be made because, as much as the doctors want to save everyone, they cannot always do so.
There are five categories to triage.
1) Resuscitation
This is for something like an active heart attack, when the person could be seconds away from death.
2) Emergency
This is something like blood loss. The person would potentially have minutes to live.
3) Urgent
Something needs to be done within the next half hour. Breathing difficulties and concussions fall into this category.
4) Semi-urgent
This could be anything that needs to be seen within the hour. Potential fractures, eye infections, and things of this nature.
5) Non-urgent
This is when someone should be seen within two hours but after the most important ones. This includes things like the common cold, or cuts that do not require stitches.
Sometimes, triage stations are set up in tents to see to those in need if there are a large number. When the 2011 tornado hit Joplin, Missouri, it hit one of the hospitals in the town. With many roads already impossible to get through, they had to set up triage tents, sometimes called field hospitals.
Interesting fact: Every year, many pets and livestock are the casualties of tornados. An extra interesting layer you can add to your story.
What could possibly go wrong?
Likely to go wrong: Your character is badly bruised after being hit with debris from the tornado.
Likely to go wrong: Your character has chest pain from all the dust and debris they inhaled during a tornado.
Possible to go wrong: Your character gets an infection from the wounds they received during a tornado.
Possible to go wrong: Your character steps on a nail as they are going through the tornado debris. They may need a tetanus shot, which were invented in the 1920’s and widely used by 1939.
Unlikely to go wrong: Your character has a dislocated hip and needs help to reset it. This would be very painful.
Unlikely to go wrong: Your character could have debris hit their car. This could cause a car wreck or even be deadly.
Improbable, but still technically in the realm of possibilities: Your character is partially crushed when a chimney collapses on them. They could lose a limb or even be paralyzed.
Improbable, but still technically in the realm of possibilities: Your pregnant character’s water breaks as the tornado hits. They are left to give birth alone in the remnants of their house.
Helpful Links to learn more:
Injury types:
Triage categories:
https://www.betterhealth.vic.gov.au/health/servicesandsupport/emergency-department-what-to-expect
Internal Bleeding:
https://www.webmd.com/first-aid/internal-bleeding-causes-signs
