The sight of shattered windows and other damage from a direct tornado hit on a hospital in Joplin, Mo., jolted Wichita hospital officials.
"Our thoughts and prayers are with them. That is our worst nightmare," said Carolyn Koehn, director of safety and emergency management for Via Christi Health hospitals in Wichita.
Wichita's large hospitals regularly drill for the same scary scenario.
Response plans are taught to staff annually at Via Christi's five hospitals and at Wesley Medical Center.
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Tornado watches in the area put staffs on alert, and warnings put plans in motion, they said.
Still, "being prepared for a tornado is very problematic for a hospital," Koehn said.
"If you want to evacuate, you simply do not have time to grab all patients and beds and take them to the basement," she said.
St. John's Regional Medical Center in Joplin had only 10 minutes' warning, she said.
So local hospitals work on plans to shelter patients, visitors and staff in place.
Staff at the hospitals get patients and visitors to interior rooms or hallways that don't have windows.
Ambulatory patients in rooms with windows are put in bathrooms next to the corridors at Via Christi hospitals, Koehn said.
When patients can't leave their beds, nurses push the beds against an interior wall and cover the patients with blankets.
Operating rooms are located in interior spaces.
Koehn said hospitals are built to rigorous standards. St. John's survived the direct hit with its walls still upright, for example.
Wesley drills for tornadoes every year, practicing getting patients to safe areas inside the hospital, said Diana Lippoldt, director of critical care and trauma and hospital preparedness.
Many go to the basement, and others to interior hallways to get away from windows, she said.
Staffers put up barriers between patients who can't be moved and any glass.
The hospitals have backup generators that come on within seconds if the power goes out, and they are tested regularly, officials said.
In addition to being prepared for a direct hit, hospitals also have to be ready for a sudden influx of patients after a tornado.
A drill last week coordinated by the VA Medical Center offered them a chance to do that.
During the exercise, Via Christi placed 162 "patients" in its hospital system, some played by real people and some by paper victims.
Wesley took in 61 fake patients.
"In every drill, we drill to what I call 'failure,' " Lippoldt said. "The reason is to make certain we find our weak points. We really push them to a breaking point to see where the weaknesses are."
Internal communications tends to be one of those weaknesses, she said.
"It's been real tough sometimes to get everybody notified of everything going on," she said.
Staff turnover and keeping contact numbers up-to-date is always a challenge. But this time, the hospital drilled with ham radio operators on a backup system.
"Everything worked well here," Lippoldt said.
Hospitals in the region are linked to EMSystems, a Web-based tool that allows them to report their status and resources.
They can report in real time how many beds are available, how many patients they can admit, and whether they need more staff or medicines.
The preparation and training make emergency planners confident their hospitals staffs can handle emergency situations, including a direct hit by a tornado.
"We enable them to make good decisions," Koehn said.
"It's best to plan for the worst and hope for the best."