A young cardiology fellow was on duty last Saturday at San Francisco General Hospital when the director of the cath lab came running into the room: “A plane just crashed at SFO!” Payal Kohli tells her story about that day, and reflects on its meaning, on CardioExchange (a cardiology website published by the New England Journal of Medicine). Here are a few excerpts:
No one really knew what to expect at SFGH, the main trauma center in SF and the closest hospital to the airport. But, within a matter of minutes, we were already functioning in full “crisis mode” with updates from the hospital’s command center coming to us every few minutes on the overhead PA system. Within the next hour, every member of the hospital’s team prepared seamlessly to receive mass casualties and care for the victims. Magically, everything was working like clockwork. There was a lot less chaos than I expected.
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As the dozens of victims started streaming in, they were more than just numbers. I was most struck by their young faces. There were a large number of patients under the age of 18 years and SFGH doesn’t have a pediatric service. Should I just treat them as adults without atherosclerosis, I wondered?
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We faced the entire spectrum of injuries, from broken bones and bruises to severe traumatic brain injury, inhalation injuries, burns, blunt abdominal trauma, rhabdomyolysis from crush injuries, and spine fractures. As cardiologists, we were largely consulted for arrhythmias (atrial and His-Purkinje blocks) as well as the obvious “rule out cardiac contusion.” We were able to discharge a large majority very quickly but a handful have remained critically ill, including some very young patients.
Sadly, in our society acts of terrorism have become so increasingly common that I have started to wonder if every physician should now have a “core competency” that involves dealing with mass casualties and disasters. I hardly felt prepared for the day I had and I think I would have benefitted from some formal training on the clinical and non-clinical consequences of major disasters as part of my training. Instead, last Saturday I received a crash course in disaster medicine.
Read the entire post on CardioExchange.
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