Shock Trauma

You. I found another planet and now I find a friend and I will find a friend and I will find a little time to look. As another holiday approaches me. But as many of you might be on the road it would take you or a trip to a place that truthfully we hope you never see and meet some people. We hope never to talk about you the way they do others that you'll hear about throughout the program. We'd like to thank the Maryland State Police who particular bill clerk's office for their assistance in the production of the show. And finally on a personal note Don Barto for writing me original theme that you'll hear at the conclusion. The shock trauma unit which I knew about or read quite a

bit came to my attention because we actually started just as the. Other states were copying their own system. I received mail from Illinois for example pointing out. The efficiency of their system how it was working. Yet here in Maryland where we originated the idea are people who are going out there on their way to help set up the Illinois system. The people in Maryland were not recognizing the fact that we had a fishing operation here. Secondly I've had the opportunity to see it in action somewhat in flying in the helicopter myself I'd hear the calls coming in over the air several times I was in helicopter and had it land so that they could go pick up a passenger up off of the ground there was an action taken to the hospital. On other occasions I'd be just ready to go to some meeting in a

helicopter and a car would come through and I'd have to cancel right talk take the helicopter and go pick up the injured person and we cancel the trip or take the automobile and I became interested in the system itself and how it was operated and when I saw the statistics of the lies that were said never being saved because a fast efficient method of getting them into the issue didn't help that they were getting it. I just thought that it should be expanded to short order. It's specialized to help the doctor all over the state facilities of dealing with the critically ill. It's a specialty that also to provide for accident victims.

It's the biggest. Shock shock from the from. Something like four people.

Coming to the country and it costs on average about thought you don't fly a single patient in the shop. Now the other helicopter systems that have been tried have cost as much as $900 but they should. So this is a very successful and that is working in association with the states. Down

in the helicopter. From the helicopter we. Have a crash. According to the rough and you're doing fine now the doctor the meet. The patient on the hell are people. Capable with the first step in any part of the body and I'm going to and the doctors in an emergency admission coming in.

Following this thread and putting it all the time and that doesn't mean in the fall. If the helicopter.

And.

For.

What. Right now one of the most important. Things to Know. Because.

Generally. That's the first thing. By looking. Outside what we call an internal human to internal going to arguments a little bit earlier but outwardly. So that when a hundred. And. Another.

Now it's. Fun. Writing and. Writing either. So they can bring the writer because. After having him. Put on a lot of halls and they are going about four minutes out of the room now starts. About 60 so they can type and

get a readout of. All the different. Your red and white. Men when you're in there when you're uncalled for and then. Everything when you're starting at A. You know other words you're not thinking about when. It was.

The ring of truth. The call to get every survivor retrieve.

Them for Them. Which is a lot of bad if you start with some of them in the first critically. You might have to operate the operation doesn't wait for you.

It's really worthwhile someone coming out of the ambulance and they're almost near death. You get into this area here. And you start to recess and you either recess or stabilizing. And stabilize. Excuse me and then move into the operating room and then you can see I'm upstairs on the floor in the shock trauma unit itself. And that's the majority of the cases we consider all the patients coming here to be our patient and the patient is going

to be away. This patient is also considered a shock trauma patient. Sometimes you just feel so bad especially if it's a young person because you do have a lot of young people coming in and you can see that they're they have a lot more to live in their life. And. When they go it's kind of hard to take in you sit down thinking maybe that could have been you. A lot is taken away from you when you see someone die but you get an awful lot out of it when you see someone make it. If you do death all the time there wouldn't be any people down here working. If they didn't know they were doing something they were getting something out of I think maybe I know I wouldn't be. There's a guy up at 9. Which is very bad but he is fine. He's going to make it and you just wouldn't believe the pleasure right now compared to when he was three weeks ago.

When it becomes impossible to move that patient can you put into words how you feel. When we come in thinking that we've given him a chance probably better than we get in most places. For the stabilization and the

station electronic and other system. Which you can do all those things to a patient. But if you didn't have sophisticated to keep them for another few days a lot of them would again critique the stabilizer which has provided

on every patient things like a pulmonary intracranial pressure or force of things that are not measured. So you have two problems. You have a mechanical problem that you can take me stitch things together and you can straighten the butt. Problem to the body to the physiological processes in the body of. A natural called

expensive and it costs an average of around about five hundred forty dollars a day to be in this particular part of the home which is too much equipment. It would be just a guess. I would get probably six million dollars. Run about 200 people all together. Including everybody that works. We have about 20 doctors and we have about

35 and this is something like a technician. It's a new concept and you got to forget a lot of the traditional teaching. And begin to think of something much faster moving dynamic than the graphic approach I think takes a particular temperament. First of all they have to be very much more expedient. Because just with children and. They have to be devoted they have to have a.

Hundred a week without any plan. Put in the same time. All of you. And on the other we have a team of doctors we have about 20 doctors specialists from all the different specialists and they're dealing with this type of every day. So again you don't go into a hospital you know taken by an ambulance and they try to find a doctor. Oh if you're seen by someone who's never dealt with you know all this from the minute the helicopter land there is a doctor and beginning treatment on the helical if necessary. There's another

meeting early with other patients for the treatment stabilization. The main problem that exists is one of education and its education position outside Baltimore and even inside Baltimore to the facilities that are available. The work is challenging. You think of the alternatives and surgical practice either in this country or in the United Kingdom you said. That's the job. A lot of people would consider those that specialize in the stuff that's been over there. But there is the continual challenge

that we're trying to get somebody through an almost impossible situation. And then there's the success that it does but there's also a system and this is this is not just the job is working within the system. It is possible somebody running through my open the Beltway for this at the hospital and often I could be dead. I enjoy nursing very much. This unit is a break for me in all honesty away from the children. I mean I just love my kitties they're direct. But it's very stimulating to work here. I keep it as you know regionally because I need more stimulation and the other you know it's really going to give you such a fantastic challenge to work here that I sort of just make room for it because you know

most of these were probably done with the sort of I think I think it's probably don't like women do things that I think about a lot in talking to other people. Like I think you would like it. And if you're talking like you know like person. Well she might say that. There must be certain that if there were people who were working with a lot of abuse some of them

and they must have a certain amount and that's doing the best they can for this very reason although it's very difficult to recover. And so the person we want to be working with because it is very the reward at the end of a long stretch of work biomes a pretty minimal but nevertheless it does have it is very difficult for. People. It's a standing joke.

I don't know why. She's a young woman who was involved in an automobile accident with her husband. Here for a while. You know everybody's. Sort of born and she makes it to see her gone through so much you know sort of really going downhill and everybody is sort of upset concerned. She it's like everything else you know her husband was rendered quadriplegic which means that he is paralyzed from here down some of the back I should say we from here down because he is able to get some of it back in a convalescent home now self. The dogs were not injured I'm not sure if they were I think. She had a lot of chest injuries an awful lot of chest injury she had a liver injury a bad liver injury bad

really bad liver injury. She had fractured ribs and she had a broken leg and she was just one of our multiple multiple injured patients. And she was doing all right. She developed what we call shock long which is just the way a long response to injury when it's been a body's been in shock for a while it's a very very lethal very few patients survive it. And we all became attached to her we treated her you know very aggressively as we do normally with lungs but it's just it's really a very very sad case. I hope I can make it through the daughters and have their pictures over her bedside so she can see them and we can see them and they're just young kids they're little bright faces and freckles. And we know that her husband you know wanted to come in to see her when she got really bad. He tried to come in to see her but emotionally with an evil till it was too much of a strain for you know

this has been so close to death. Maybe four or five times. And it's very hard for us going to see her like this like on mother's day her little kid brought her special gifts. Being a mother it's hard for me to see that but. You know she's mine that lot of us have become really attached. You know we're just really hoping that something will happen to save her but it's just really difficult. She's had almost all the complication. It's just really hard to see her pictures of the kids and nobody you know to save yourself get help there that they are got everything. So. Somebody decided that decided. Might not enter but exhibited it. Good job

but not one but not one of the physicians from another hospital said it was really true. He said he feels when he has a critical patient and no blood available in his hospital and nobody to help you nobody to help the patient. And with helicopters it's like such a thrill such an emotional release for him he said. Just to know that there's someone there to help. I think I've been here three years and the advances that we've made and why are just fantastic. I get absolutely hundred percent but then I have a terrible time. Yes we do get

involved with many of us get extremely involved. You know if I can talk about this now but I used to from before we have a nurse who works with us now and many of us who do get upset and who do get involved have families and who do private patients die. She has worked with us a lot to help us see that this is an asset and not a liability that you know it's difficult to reach out of motioning to a patient and to a family you know who you know are facing knowing that you know we ourselves are going to be hurt when a patient dies. But you know there it is you got this emotion inside of you that's got to be some way. Still you know I've heard you say well I can't. They said. Talk about it. I don't cry so much when the patient dies if it's been

done. That's it. I mean obviously there's somebody bigger than we are up there has decided this is it. Because when you've got the support no medical man is working and still you can't bring. That's it. When I cry as when I see the doctor standing by the bed just looking good because it's all over. There's nothing else it. When I see the family on the side of the family with the patient that cracks me up you know stand there and I'll get tears in my eyes were. Hysterical to think any one of us really control that kind of thing which I think people are a little surprised to see because there is this. Around the border get upset. If you took these things home with you they would destroy you as a person.

This hospital that you have to make up your mind that you're going to move all loose and go home. Children have to go home and they think of a friend who is very much like me who has come to you know to suggest to be able to talk to her is a big relief. Again that's the nurse that we have has conferences with us that allows us to work out our feelings and talk about anything like why this particular doctor yells at us all the time and how we can handle that situation to how we felt about a 10 month old little boy. Was that my neighbor's car. You know we we do discuss things like this in a group so that we can you know get strength from knowing that other people you know feel the same way and release our emotions and try to come up some kind of solution.

His death was very difficult to take. What was even harder was. This is difficult for me to say to his mother wrote a letter to us. You know she accepted the fact that he died. She said it was God's will that she would accept it. This always upsets me because he was such a cute little boy. But she asked me if she said you know could someone just write to me and let me know how it was when he was here. You know when you get back I forgive me just like if you want to read the letter bride because it just she was really reaching out to us and she wanted to know about him and it was just very difficult you know to be able to even talk to her on the phone right back to her. But we did you know and that's what I can't talk. Difficult but that's what it was just very difficult. In fact become attached.

I think inevitably when you're dealing with human you have to detach yourself. Decision to feel less emotional about it so that you can view the proof of the problem and the better for the position that they're still feeling when those are the violet that you were you were in your you know a movie like this where. I wouldn't know where but I was more I was more on where I was

going and what would happen. You remember. The first thing you remember is the next thing you remember going you know the next thing you remember. I don't rush you know. He was rather modest when he was talking about himself but he was

bilateral fractures. That's where he did have a blast. We had a lot of trouble. We had a lot of trouble trying to get in but the best part along here in the rest of the fight here is actually survive a ruptured aorta. But his was caught very early. He was coming out of this just because of the pressure so we could see something. It is available downstairs. So it was just a matter of minutes before the surgery had liver kidney complications. I think I. Was really in fantastic shape.

The fact I want to take care of you.

That's kind of like you know some of the Russians

some of them just like little rock throwers. But. If I had my glasses. And he went through

it was me. Mr Woods 67 says he wants to you know I think the only important thing is can we create a total system for the state that will result in saving lives. If we can do that. It's going to cost us some money to do it. It's worth it. You just can't put a value on human life. I don't think any person that's in that position would say to you well how much money should we spend to save human life. I don't think that ought to be considered in calculating the value system I think the question is can we save human life. Can one person if it's just one I think last year the total I'm just trying to recall was something like fifty nine people

who were brought into the shock trauma unit who would have died if they hadn't gotten that fast treatment that they received and the specialized treatment that we see. They call them miracles. Well there are Americans that that happened because of the getting them into treatment immediately. Now how can you calculate the value that you can't calculate what a person's life is worth what is the governor's role in a system like this. Certainly one quarter or another it becomes a medical problem but I was a governor. It's a total medical problem. It's not a problem of government from the point of view of treatment that's not where the governor the governor is involved with the government. Our role as I see it is to coordinate it put all of the elements together into a coordinated system not to have it become enmeshed in any bureaucracy that can slowly grind the whole but to put

all of the pieces together and make them work. And that's what I think our role is and that's what we're attempting to do. That's why as far as I an executive order creating this statewide system the job is to make the various elements fit into the total plan. The medical aspect will be handled by the medical people. Let's talk about the medical people Dr. Kobi specifically. Thought Dr. Kelly has been doing this kind of work was instrumental in creating it it has been a pioneer in the field and I feel that he has contributed tremendously to making unit the success it is at the university. He has designed plans for statewide implementation of an overall program and I think is his knowledge is ability.

I just feel that if we're lucky to have a man of that caliber in that position we are still you go to a friend who was involved in the drill with the well this was another incident that really made me realize the importance of having a coordinated system. They were doing a great job in the trauma unit. But there was no statewide coordination. In that instance friend of all of us here who had been working here for years the chief clerk of the legislature was seriously injured and I said that on the Last Night of the session on his way home he was seriously injured. He was taken to Frederick Hospital where they diagnosed his injuries because untreated because he didn't have what they needed. He was then moved to the Egger townhouse. By this time the people in the shock trauma unit had been notified. Fortunately they sent a helicopter up to the

Hagerstown hospital. They had it on its way without even knowing the extent of the injuries but knowing that they were serious about it and they picked him up what it meant to the University of Maryland Shock Trauma. He called me in the meantime to notify me about the incident I went into the hospital and got there early in the morning. I saw what they were doing form there and then realized that here was the perfect illustration. He was injured. There was no coordination no one to make decisions no way that decision to be made what hospital to get the best treatment or who should handle it. How should it be that there had to be a state wide coordinating system because people who are injured in these accidents and decisions have to be made on the spot the difference of minutes can mean a difference of saving lives. Fortunately Jim got to the hospital. His

life was saved by the fact that they had moved quickly without even knowing the total extent of the injuries. And here was all the equipment to treat that kind of injury and it was serious extremely serious it was doubtful whether it was live like I did. Would you really and will conclude this if you hear the story. Mr. Miles when you're in shock. Well that's something that I haven't talked about. Hardly anyone because this scene was right before they were taken up to the operating room was very early in the morning. He was well just in desperate condition. While you could hear him just move his arms he couldn't talk he would say anything. He gestured for a pencil and someone hand him a hand saw the move. He was lying flat on his stomach. Just that someone

held the pad he wrote a note to me and said Do anything you can. I want to live and I still have that note that he gave me that morning. And you just had to be there to feel what that meant. Desperately and of all fighting to live and how can you put a dollar value that you think short term of service like this a question about. I think they certainly do and I think they do a tremendous job and I think people are. Very fortunate to have something like this type of existence and I think when we're able to put it all together to a total statewide system I think people realize. Something like this what the state we are here for your service. We're.

A family with funny funny funny funny funny funny funny funny funny funny and. Recorded on location by the barrel and Center for Public Broadcasting.