The Logistics Of Mass Trauma: What Happens At The Hospitals
PITTSBURGH (KDKA) — KDKA’s Dr. Maria Simbra has more on the emergency protocols in in mass casualty situations.
HOW DO FIRST RESPONDERS DECIDE WHICH PATIENTS GO TO WHICH HOSPITALS?
Patients need to be stabilized as quickly as possible, so that often means taking them to the nearest hospital that can handle the trauma. Shorter distance will save you time.
This is especially important for those most severely injured.
For those who have injuries that require medical attention, but maybe not as life threatening, they will go to other centers in the area. You don’t want to overwhelm one center with all the cases.
WHAT HAPPENS WHEN THE PATIENT GETS TO THE EMERGENCY ROOM?
A couple of assessments take place.
1. Primary assessment — Are the patient’s vital functions are okay? Is the airway open, is the patient is breathing, is the heart is beating and pumping, is the blood pressure okay? Also their level of alertness — are they awake, can they talk, are they confused, unconscious? Resuscitations start at that point, if necessary.
2. Secondary survey — a head to toe exam looking for any inobvious injuries. X-rays and ultrasound are usually part of this. Doctors are looking for collapsed lungs, bleeding, and any other urgent problems that may not be immediately apparent. Once they have a full picture of what they’re dealing with, the patient goes to the OR to have those addressed.
WHAT HAPPENS IN THE OR?
We heard a lot about deep penetrating injuries to the abdomen, so the surgeon has to open the belly to take a look inside. The surgeon is looking for damaged organs (liver, stomach, spleen, intestines, pancreas, kidneys), sources of bleeding.
Once the injuries are repaired, the patient may go to regular post-operative recovery. But if there is any concern about vital functions or critical injuries, the patient will go to intensive care. Sometimes they may require a second or third operation to deal with all of their injuries.
COMMUNICATION WITH FAMILY?
Usually a social worker who is part of the trauma team talks to the family while the patient is still in surgery. Afterwards the doctor will come out to discuss things with the family.
CAN’T ANY EMERGENCY ROOM DO THIS?
Managing trauma is a team effort. You need a full array of doctors, support staff, blood bank, operating rooms, and so on. This is why there are designated trauma centers.