Saturday, September 20, 2008

Motor Vechile Accident

I am on call this weekend. Normally, I go in at 8, make rounds on the wards and then head home for a period of time before I get a call from the ER to see pts. Today when I got to the ward, they mentioned that there was an MVA and there were lots of pts in the ER. I kept rounding, knowing they would call me when they needed me. Not 5 minutes later, they called for help.
I find 9 patients in the 5 bed ER, they were on the floor, on stools, and anywhere there was room. There were nurses from the wards, college of nursing students who weren't working, and CWHs from the wards all helping out. As a result, things went pretty well. I triaged the pts based on severity and made my way through them all, leaving orders for the nurses to do on each. I went back to the wards while I waited for the Xrays to be done, and to give some of the head injury pts time to see if they would improve or not.
When I got back, I found one pt, who had a head injury, open tibia/fibula fx, and obvious fx of his R humerus, had died. The others were doing somewhat better. Of the other 8 patients, 2 were admitted with head injuries, 2 sustained arm fractures, many had small lacerations, abrasions, and musculoskeletal pain. All were thankful to be alive.
The story I got from the patients was the driver was drunk. They came up to a car, and were passing it, but hit some potholes. When they hit the potholes, the car kind of jerked and the driver tried to pull the wheel to straighten it, but then the car turned over. The guy who died, ended up underneath the car. I am amazed that there aren't more MVAs here based on the conditions of the roads and the way folks pile into drive, but thankfully there aren't. This is the first major MVA I have seen. Previously, I have seen one or two pts come in from an MVA, but never something like this.
In case you were wondering what the ER bill is for 9 MVA pts in our hospital - it came out to 580K. This is approximately $238 - not bad for an ER visit.