Data lacking on hurricane-related injuries

Before Hurricane Irma arrived, Dr. Kenneth Alexander decided to put together a list of anticipated short-term and long-term injuries after the hurricane so that he and his colleagues could better prepare at the hospital.

He started researching the current literature, and to his surprise there were very few studies on the topic. Of the existing ones, most were conducted after major storms like Hurricane Katrina and almost none focused on children.

It’s not that hurricane-related injuries are unknown. Most physicians and public health officials have a pretty good idea what happens before, during and after the storm. But what’s lacking is a database to better track trends.

“Data helps you with planning,” said Alexander, chief of the division of infectious diseases at Nemours Children’s Hospital in Orlando.

If data shows that there are more puncture wounds, then the hospitals can anticipate having an extra orthopedic surgeon on staff, he said. Or if there are more outbreaks of diarrhea in shelters, then they can stock their shelves with more hydration.

“And it helps us to warn people,” he said.

Health officials already issue plenty of warnings ahead of the storm, some of which stem from hurricane-related death data that’s submitted to the state by medical examiners.

Carbon-monoxide poisoning is one of them.

And Dr. Stephen Nelson, Polk County’s chief medical examiner, confirms it.

“Carbon-monoxide poisoning is a huge problem,” he said.

Health officials also warn people about climbing ladders, chopping up trees and stepping into standing waters, even though inevitably patients end up in the emergency room shortly after the hurricane with those injuries, causing an ER surge after the storm.

Florida Hospital Orlando, for instance, boosts its ER staffing 120 percent after the hurricane.

At 5 p.m. Monday, one hour before Orange County lifted its hurricane curfew, the hospital’s ambulance bay was filled with trucks.

Dr. Max Baumgardner, assistant medical director of the emergency department at Florida Hospital Orlando, who wasn’t scheduled to be in that day had come in at 10 a.m. to help.

He didn’t have to look at the medical charts to list the types of hurricane-related injuries that were walking in to his emergency room after the hurricane.

Cuts and bruises. Broken bones. Chronic diseases. Heart failure. In short, patients who injured themselves while cleaning up their yards and patients who didn’t get to see a doctor on time because of the hurricane.

“And in the next couple of days we’ll get more people who have evacuated from other parts of Florida,” said Baumgardner.

Florida Hospital Celebration, which is near a hotel for displaced South Florida nursing-home residents, has had a surge of elderly patients, Baumgardner said.

Although the types of injuries and the volume of patients after hurricanes are unpredictable like the hurricane itself, data can still be helpful.

After reviewing the few studies he could find, Alexander divided hurricane-related injuries into three categories.

Injuries that occur during the hurricane: Drownings, carbon-monoxide poisoning, ruptured appendix and trauma due to flying objects.

Injuries that occur afterward: Wounds, falls, respiratory infections, mosquitoborne diseases and diarrhea.

And long-term injuries — especially after disastrous storms — including posttraumatic stress.

“If I were a [public health official], this is a study I’d be pushing for: To catalog these hurricane-related injuries,” Alexander said.