Joplin hospital staff took action during disaster
If you haven’t already, take 90 seconds to read Tulsa World reporter Michael Overall’s brief, powerful account of how emergency preparedness translated to emergency action at the hospital caught in the center of the May tornado in Joplin, Mo.
Photo by Red Cross: Carl Manning GKCARC via Flickr
The staff had practiced severe weather drills and evacuations hundreds of times but, as one administrator told Oklahoma colleagues, “There’s no way you can plan for an F-5 tornado.” Nevertheless, Overall writes, the well-drilled staff of St. John’s hospital “evacuated all 183 patients in just 90 minutes with no major injuries,” a sentence you won’t appreciate until you read Overall’s narrative based on a hospital administrator’s talk at a conference for regional emergency workers.
For those of you looking for story ideas, you might look into local hospitals’ disaster plans. Have they really planned for every contingency? Certainly there are things no one can plan for, but it’s worth reading the story from this hospital and evaluating disaster plans with those events in mind.
For more, read AHCJ’s roundup and review of Joplin tornado coverage.
Giffords’ surgeon credits system, multidisciplinary approach
With the news that U.S. Rep. Gabrielle Giffords, who was shot in the head in Tucson in January, will travel to Florida to watch the final launch of the space shuttle Endeavor, which will be commanded by her husband, there may be renewed interest in her medical history and treatment.
Lemole speaks at Health Journalism 2011 in Philadelphia on April 16.
Attendees of Health Journalism 2011 heard her neurosurgeon, Dr. Michael Lemole, describe his response, and that of the whole team at his hospital, in the minutes, hours and days after Giffords’ injury. In the speech, he credited the hospital’s multidisciplinary approach as well as the fact that the system worked as it was intended to on that day. He gave details about Giffords’ treatment and brain injuries in general that health journalists might find useful as Giffords re-emerges in the news.
If you weren’t able to make it to the conference, now you can watch Lemole’s keynote speech online.
Some articles about the talk:
- Neurosurgeon reflects on time in the media spotlight
- Giffords: A poignant presence, but out of view
- Surgeon Who Treated Gabrielle Giffords Talks About Dealing with Media
- Surgeon describes details of Gabrielle Giffords’ trauma care
- An exclusive interview with Gabrielle Giffords’ neurosurgeon
Why Detroit’s emergency services are lagging
The Detroit News‘ Charlie LeDuff tried to figure out his city’s abysmal ambulance response times, and had a tough time finding excuses for why they are so far behind the national average, though staffing cuts and budget shortages certainly played a role. He wears his frustration on his sleeve and the article’s brutally incisive as a result. I’ll do my best to summarize, but it’s certainly worth a read.
One problem, according to a 2004 city audit of the Emergency Medical Services (EMS) system, is that Detroit is the only major American city that does not allow a firefighter or a police officer to aid a victim before the ambulance arrives. Another problem is substandard communication equipment. Since that report was issued, at least two hospitals have closed and the EMS system has been decimated by staffing cuts causing ambulances to drive farther.
The national standard for ambulance response is eight minutes, and some Detroit suburbs have it down around five. Nobody’s sure how long Detroit ambulances take, but it’s clear that it’s well beyond the acceptable threshold. Fire Commissioner James Mack Jr. said the departments doing the best it can to maximize resources amid budget constraints, LeDuff reports.
Mack made a claim to Fox 2 News a few weeks ago that the average response time in Detroit for an ambulance to arrive on a 911 call is 12 minutes — even while admitting that often there are no units available to get to calls.
According to that 2004 audit, the two-year average at that time was about 12 minutes. And that was before the city cut its paramedics and emergency medical technicians by nearly 40 percent.
Are emergency drivers distracted by technology?
“Driven to Distraction,” a New York Times series that looks at the “dangers of drivers using cellphones and other electronic devices, and efforts to deal with the problem,” turns its focus on first responders, such as police and paramedics.
Photo by rKistian via Flickr
Reporter Matt Richtel points out that emergency drivers are often required to use technological gadgets while driving at high speeds and negotiating heavy traffic to get directions and transmit information about patients.
Data does not exist about crashes caused by police officers or medics distracted by their devices. But there are tragic anecdotes.
The New York City Fire Department says ambulance drivers are not supposed to use on-board computers while driving but “medics and E.M.T.’s in New York and elsewhere say that although they are aware of the rules, they do use their on-board computers while driving.”
6-foot rule separates San Diego paramedics, H1N1
Voice of San Diego’s Randy Dotinga explains exactly how the fear of H1N1 has transformed every step of the health care delivery process in the Southern California city, which has been hit particularly hard by the virus. Dotinga focuses on how paramedics’ routines have changed. “To protect themselves,” Dotinga writes, “paramedics are essentially using the same precautions they would against infectious tuberculosis – something they hardly ever see.”
Dotinga says the changes become evident as soon as the paramedics arrive on the scene. Before H1N1, they’d walk right up to the patient. Not anymore.
Now, paramedics across the county adhere to a “Six-Foot Rule” when they suspect a patient has a respiratory illness. “If you’re six feet away even without your protective equipment for a short period of time, you’re not likely to get infected,” said Haynes, the county official.
If a patient has possible flu symptoms, the paramedics put on N95 respirators. They began wearing the respirators instead of ordinary masks about a month ago. Paramedics will put on eye shields too. Many paramedics hate to wear them, and forget to put them on.
In this environment of extreme care, not even the ambulances are left to go on as usual. These days, in addition to their regular regimen of extreme sanitation, they visit a nearby fire station a few times a month. There, they are nailed with a super-powered germicidal fog that ensures no microbes, nefarious or otherwise, are going to linger for long.
Does the six-foot rule really work? What about masks?
Maybe. Your view of the effectiveness of social distancing likely depends on where you stand on a particularly contentious issue: airborne vs. droplets. If influenza is spread primarily through droplets (as the CDC says it does here, and here), then it’ll have a tough time spreading beyond three feet unless it’s smeared on a surface. In this case, then, the six-foot rule is an effective way to slow the spread of the virus, as are masks.
If, however, you believe the virus is airborne then it would be able to cross the six-foot gap and you would need, at the very least, an N95 respirator (a mask which filters out at least 95 percent of airborne particles) to protect yourself. In this case, though, it’s important to note that according to some recent research, an N95 won’t offer any more protection than a regular mask.
According to the Institute of Medicine, we haven’t yet heard the final word on influenza transmission and further research is required (PDF). In the meantime, most providers are erring on the side of caution. Check out AHCJ’s primer on controlling pandemic flu for further information.
(Hat tip to AHCJ board member Maryn McKenna for pointing us in the right direction.)
Denver’s ambulance system said to be ‘broken’
Tom Burke Arthur Kane and Tony Kovaleski of KMGH-Denver, used the example of the 33 minutes it took for ambulances to reach a major December airline crash to investigate flaws in the city’s emergency response system.
It took four minutes until the first ambulance was dispatched from Interstate 70 and Colorado Boulevard, which is 19 miles away. That ambulance was dispatched Code 9 — a non-emergency designation where the paramedics drive at normal speeds without turning on lights or sirens.
“There’s no reason that I can conceive of that a response to a confirmed crash of a commercial airliner, that the initial response would be non-emergency for transport ambulances,” said Bob Petre, a long-time Denver Health paramedic, who is president of the union. “It’s unbelievable.”
Sideras, who, along with Lindsey, reviewed documents obtained by the CALL7 investigators, said Denver’s Ambulance system is “broken.”
“There was a true failure in the system,” Sideras said.
Denver Mayor John Hickenlooper vowed the city’s sluggish response would not be repeated.
“When you’ve got a red alert, you still need to send the resources immediately that that situation is going to need,” Hickenlooper said. “It’s unacceptable. You can’t have from the moment the crash happens, an ambulance there in 33 minutes. That will never happen again.”
The Poynter Insitute’s Al Tompkins interviewed Kovaleski about the project. Kovaleski discussed the impetus for the story.
We have known about the problems inside the dispatch center and with Denver Health for nearly a year. Since last May, we have aired almost a dozen stories exposing problems with ambulance response times in Denver. Following December’s plane crash, it was a logical request to see how the ambulance system worked on the night of a mass casualty incident.
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New at HealthJournalism.org
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