Not long after the tornado hit Greenfield, Iowa, residents were already using skid loaders to clear streets. With the hospital damaged, a medical triage center started at the local lumberyard. Paramedics and police officers from across the western half of Iowa were speeding in to help.

“Everybody became little makeshift ambulances,” said Ray Sorensen, a member of the Iowa House of Representatives who lives in Greenfield, and who said he helped with the rescues after racing back into town shortly after the storm hit on Tuesday afternoon. “We pulled a guy from the rubble and put him on a little makeshift stretcher that we made, threw him in the back of a truck.”

On Wednesday, the roughly 2,000 residents of Greenfield began to get a clearer look at the destruction all around. Gov. Kim Reynolds said some areas had been “flattened into debris.” Officials said multiple people in town died and more were injured, but had not yet said how many as search and rescue efforts continued. In nearby Adams County, one woman died from storm-related causes, according to the medical examiner.

Around Greenfield, the scenes of destruction began abruptly, with lush green yards transitioning into the chaos of splintered lumber and lawns littered with household items — a cooler, a sink. Outside the local hospital, shredded tree branches were scattered across a lawn and a board had shattered the window of a parked car.

As rescue crews sorted through the wreckage, residents were beginning to reflect on a proud community that was indelibly changed.

“It’s just the skyline of the trees: there’s so many old historic trees in town that are gone,” Mr. Sorensen said. He added: “It’s a completely different town now.”

It has been a particularly brutal spring in Iowa, which is still recovering from an outbreak of tornadoes last month that caused extensive damage in the small town called Minden, about 70 miles from Greenfield.

“I was just in Minden,” Ms. Reynolds said at a news conference on Wednesday, “and that was horrific. And I think there’s even more debris and just more impacted here. So it is just horrific. It’s hard to describe until you can actually see it, the devastation.”

Christine Hauser and Joel Petterson contributed reporting.