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Prepared For Disaster
Bill Cioffi '77, heads treatment of Rhode Island fire victims

As smoke poured from The Station nightclub in West Warwick, Rhode Island on February 20 in what would turn into one the nation’s deadliest fires, Dr. William Cioffi was preparing his staff for the onslaught of burn victims that would soon arrive.

It was a moment that the chief of surgery at Rhode Island Hospital had been preparing for most of his life, really — first as a medical student at UVM, M.D.’85, and later as a surgeon in the U.S. Army where he spent 11 years traveling the globe rescuing and treating badly burned U.S. military personnel.

Cioffi, one of the nation’s pre-eminent burn specialists, was perhaps the ideal man to have coordinating the disaster relief effort that cruel winter night. Modest in nature, the UVM undergraduate and med school alum will tell you that luck was involved in keeping alive all 64 burn victims treated at the hospital that night — that the outcome may have been different if patients hadn’t started arriving at midnight during a shift change allowing for an optimally high number of personnel to help.

It wasn’t luck, however, that Cioffi had been trying to turn Rhode Island Hospital and the entire state into a nationwide model of an ideal trauma system. Because of these pre-disaster efforts, Cioffi and his staff had plenty of saline solution on hand to feed intravenously to patients to prevent fluid loss, something that years ago commonly caused kidney failure resulting in death.

“We took over the entire 5th floor,” says Cioffi, whose wife Theresa Graves MD’85 is a general surgeon and played a critical role in saving patients that night. “I asked if the hospital was going to support me. They said ‘yes,’ and then let me do whatever I wanted.”

Cioffi’s expertise in the areas of resuscitating patients in the first 24 hours by supporting the lungs of victims with inhalation injury, and the more recent advance of quickly removing any dead tissue and getting skin grafted and wounds closed, proved critical. Cioffi was praised for his mastery of these relatively recent advances by a number of national media outlets including The New York Times and NBC’s “Today Show,” where he was interviewed by host Matt Lauer.

“A lot of things worked out fortuitously,” Cioffi says. “But I truly think if we hadn’t gone through that year of planning, it would have been a different outcome. In reality, we could have cared for another 40 patients that night. I was told we were going to get 100 people and we were prepared for that.”

Cioffi owes much of his seemingly tailor-made training for the nightclub fire — fourth worst of its kind in U.S. history — to his time spent as a surgeon in the Army. It wasn’t long after spending more than a decade at UVM as an undergraduate ’77, med student, and resident, that Cioffi joined the military and started flying around the world in a helicopter rescuing burn victims. Among other missions, he was part of the medical team called to Ramstein Air Force Base in Germany for the air show crash there in 1988 that claimed the lives of 70 people.

“I got my feet wet in burn disaster management in the Army,” Cioffi says. “We were often in the air for 12-to-24 hours, so we had to find ways to treat burn victims safely for long periods of time right after being injured.”

Yet Cioffi had never dealt with a disaster of the magnitude of the Rhode Island fire, which claimed the lives of 100 people and injured 200 more. But his prior experience, coupled with the development of a Hospital Emergency Incident Command System and an ongoing effort by Cioffi to make Rhode Island a nationwide model for disaster response, made the night of February 20 a case study in proper trauma systems management.

“I came here because it’s a small state and thought I could make Rhode Island into the ideal trauma system,” Cioffi says. “After years of not thinking that was going to happen, I now think it will become a reality. Each state has different needs, so if we’re not a model, our system will at least work very well for the people of the state.”

—Jon Reidel