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An Atypical Day in the ED
July 16, 2009
Morrow County Hospital might be a small rural healthcare facility, but on May 22nd, ED staff proved they were up for the challenge of a multi-trauma event. “It was actually a somewhat slow to average day before we got the patients from the motor vehicle accident,” recounts Dr. Mark Davis, one of the ED physicians at MCH and an employee of Premier Health Care Services, about the events that unfolded during his shift.
Around 2 PM on a sunny Friday afternoon, a tragic two-car accident occurred at the south edge of Mt. Gilead, Ohio, injuring eight people. Dr. Davis and fellow Emergency Room staff heard the EMS call go out and readied themselves. Within 41 minutes, EMS transported eight patients to the seven-bed ED.
Hospital CFO and designated Incident Commander Joe Schueler implemented a “Code Yellow,” the hospital’s plan to mobilize personnel and resources during a mass casualty incident in the community. Cindy Marsh, VP of Patient Care Services coordinated efforts to call in the additional ED physician support of Premier’s Eric Hansen, MD, Medical Director, and Jesse Frank, DO, to help treat the eight patients, five of whom were classified as Level 1 Traumas.
Dr. Davis was the only ED physician on duty that afternoon when the patients arrived. Cindy Marsh recounted to the Morrow County Sentinel that she successfully convinced MedFlight to send helicopters immediately after first being told none were available. With the collaborative efforts of Teresa Roe, RN, ED Manager, all the nurses, x-ray technicians, and the hospital’s Radiologist, Dr. Davis intubated 3 patients, put in a chest tube, ordered a blood transfusion, and addressed multiple fractures prior to physician reinforcements arriving.
“In the midst of these events, I felt like everything was happening in slow motion,” said Dr. Davis. “I could see the seriousness of the situation in all the staff's faces. I remember staying very calm. I think the calmness rubbed off on others. Morrow sees trauma, but not with this magnitude or severity. In my 17 years with Premier, I’ve never seen an accident this bad with this many serious injuries.”
Dr. Frank was relaxing at home, preparing for his 8 PM shift when the hospital operator called to alert him of the Code Yellow and request his services immediately. “As I pulled into the parking lot, I saw the fire department trucks blocking off a section for the helicopters to land. Two sat on the ground and two hovered overhead. As one took off, another landed. In my 20 years of practice, I have been called twice before to help in the ED, but never have I seen anything like this!” recalls Dr. Frank. “I immediately asked where I could be of help.”
Dr. Frank said, “Eric Hanson and I took care of one accident patient that had a displaced humerus fracture. Eric reduced it, and I suggested the type of splint to apply to hold it in place. The patient from the accident that I took the most time with required extensive suturing of her face from the trauma she sustained.”
Dr. Frank credits nurse Susie Mangrum, RN, with tracking the patients and who was treating whom. While doctors cared for victims of this multi-trauma accident, other patients in the ED needed emergency care. Dr. Franks says, “One patient I cared for had chest pain and had to be seen in the hallway. Once we did an EKG, we moved her to another room, so we could follow our standard chest pain protocol.”
The five stabilized Trauma 1 patients were flown to Grant Medical Center in Columbus, Ohio. Prompt and efficient action by the staff members of Morrow County Hospital allowed all eight accident victims to be transported by 4:25 PM; the last patient left the Emergency Department just 1 hour and 19 minutes after admittance.
Grant Medical Center emergency physician, Michael Pallaci, DO, was on duty when the Level I trauma patients arrived by helicopter. He noted that Grant has more resources than Morrow County, “The influx of these trauma patients when they arrived stressed our system to the point that Grant went on diversion for several hours. The accident victims had received great care, were all stabilized, and everything that should have been done was done. For the first time in my 11-year emergency department tenure, I felt compelled to call Morrow County Hospital and pat them on the back.”
Dr. Davis said, “The staff at the hospital was nothing short of incredible, and it was a pleasure to work with them.” Dr. Frank agreed, “We are a family at MCH, we work together every day to do our very best, now we have truly shown what can be done when you work together as a team. I could not have done the job without the entire team there to help out.”
Diana Fisher, President and CEO of Morrow County Hospital added her deep appreciation to everyone involved. “As a hospital team, you prepare and practice for these types of situations, so you are ready at a moment’s notice. When you experience the situation, there is a bond beyond comprehension. I’m extremely proud of everyone and want to thank them for what they did to save patient lives.”
Having an emergency department staff and physicians with extensive experience and advanced trauma training helped the hospital “pass the test” of how well they handled this extreme situation. Dr. Davis, with 17 years of emergency medicine experience is board certified in emergency medicine and family practice. He is also a Basic Life Support (BLS) Instructor, a NREMT – Paramedic, Advanced Cardiac Life Support (ACLS) Instructor, State EMS Instructor and is trained in Pediatric Advanced Life Support (PALS). [Dr. Davis has been a Premier Health Care Services physician since July of 1992 and currently works in the ED at MCH, a Premier client hospital since 1996.]
Summoned to the Emergency Department and arriving in 20 minutes were Eric Hansen, MD, MCH Emergency Medical Director; and Jesse Frank, DO, emergency physician.
Dr. Hansen is board certified in family medicine and trained in Advanced Trauma Life Support (ATLS), Advanced Cardiac Life Support (ACLS) and Pediatric Advanced Life Support (PALS). [Dr. Hansen has worked for Premier since April of 2005. He is currently the ED Medical Director at MCH.] Dr. Frank is board certified in family practice, board certified in hospice/palliative care and is also certified in Advanced Trauma Life Support (ATLS), Advanced Cardiac Life Support (ACLS), and Pediatric Advanced Life Support (PALS). [In addition, Dr. Frank is a clinical assistant professor for OSU and OU. He joined Premier in January of 1996 when they were awarded the MCH ED contract, continuing his work in the emergency department.]
The hospital’s emergency nurses are required to have advanced trauma training in Cardiopulmonary Resuscitation (CPR), Advanced Cardiac Life Support (ACLS), Trauma Nurse Core Course (TNCC) and Pediatric Advanced Life Support (PALS).
As a result of the events on May 22nd at Morrow County Hospital, Dr. Mark Davis has been nominated for the Jana Banks Award for Clinical Excellence through Premier.
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