Injuries from Motor Vehicle Accidents: What is a Trauma Center? Why Should I Care?

Emergency Room, Chealion, FlickrWhere should I go?

When I had my motorcycle crash and received a severely broken leg, I had no idea that the hospital I had chosen to be taken to for treatment was a level IV trauma center. Nor was I aware that Washington State uses a 5 level rating system for the various hospitals/trauma centers associated with these hospitals.  The trauma nurse and doctor at Northwest Hospital looked at my x-rays and discovered that they were going to stabilize me for transport and that would be about it. I was going to need much more surgical specialty personnel than was immediately available for them to muster. Oh, joy.  Another ambulance ride.

The pain from being moved around for a dozen x-rays was getting to the point where medications alone weren't effective and it was time again for distractions and daydreaming - taking my brain away from the pain, like with the Shoreline paramedic talking with me about my once- beautiful bike (Grrrrr!). Yup, that worked and now that I know it will only work for a couple of minutes, I started thinking about trips my wife and I have taken - standing on the observation platform atop the Eiffel Tower in Paris, gaping at the Crown Jewels in the Tower of London, watching humpbacked whales in the Strait of Juan de Fuca ; the vivid, Technicolor type memories that are forever etched in your mind. Those memories are the ones that seem to work best to push pain down and away. I still felt it, but the pain was much more tolerable and allowed the medications to work better.

Trauma Center Ratings

Level V (5) is the lowest rating for a Washington trauma center and level I (1) is the highest. If you live in Washington, Idaho, Montana or Alaska and need a level I trauma center, you will be going where I wound up - Harborview Medical Center, Seattle, The State of Oregon has two level I trauma centers in Portland to help cover that state and SW Washington.

The trauma center with a level I rating is going to have 24/7 staffing and on-call availability of every specialty doctor, nurse, anesthesiologist, and technician that severely injured people might need, including burn and plastic surgeons.There will also be on-site most diagnostic and imaging devices these specialists will need to help fix you up.  In my case, it was for the orthopedic surgeons. (Yay, HMC Green Team!) The centers with levels II, III, IV and V will triage patients, and if they can be stabilized, they will send them off to a higher level facility that will have necessary staff waiting or on the way when the transferred patient arrives by ambulance or helicopter. There are many rules of triage and transfer these trauma centers follow and these guidelines vary from state to state. Look up specifics for your state or states you're likely to travel through as part of a pre-trip planning guide. It could help steer you towards a better choice and eliminate unnecessary transferring. And unnecessary pain.

Triage at the Trauma Center - Three Days Without Food

One thing to keep in mind about trauma centers is that they are very busy places, indeed. The Friday I crashed was the day before the Seattle Seafair festivities began and man, was that hospital busy. Remember I mentioned triage?

If your condition is relatively stable or can wait for treatment, you will probably wait. Here's where the letting your mind wander technique can help, especially if you're bored with watching tv or there's no tube where you've been stashed. Once a code blue is called on your floor, you will have to wait for more pain meds until the emergency is over and your nurse is freed up. You may have to deal with the pain one on one, using the power to reduce pain your mind has built into it - you against the pain beast. Kick the beast where it hurts, but remember to stay calm, relaxed,centered, sitting on the beach or wherever it is you choose to go.

The nurses called it "getting bumped" or as I found out, no food for three days.

Each time I was scheduled for the first surgery to install an external fixator (lovely piece of equipment - Google it to see examples), someone more seriously injured would come to have their life saved. Usually. Not everyone who made in in survived. I didn't have anyone die next to me, but a temporary roomie did.

Once, I made it as far as having the surgeon initial my leg and have the sleepy-time guy go to get the good knockout drops when Nurse Killjoy came in again to bump me. No ill will towards those bumping me, but three days without food made me a little cranky. Seafair weekend in Seattle gets a lot of torn-up people into the hospital, and depending upon what is going on at the time you're ever admitted to a trauma center, be prepared to wait.

Distraction Pain Control

Practice a little distraction pain control at home before you really need it.

Practice controlling your breathing and breathe like an opera singer - slowly, from the diaphragm, up and down, not in and out. I got pretty good at it and found that I could slow my heart rate quite a bit and lower my blood pressure (being hooked up to monitors made it easy to quantify). You can learn how to do it, too, Use it to work on relaxing pain away a little at a time, one spot at a time.

Dave

Shoreline, WA

What To Do After Your Motor Vehicle Accident

Ambulance Returing to Hospital, Chris Wong, FlickrYou Crashed Your Motorcycle. Now What?

All of the people you need to process the scene of your incident have arrived, you're in a lot of pain, and they all want to ask you questions and be given answers at once.

If you are lucky to have an adrenaline surge (as I did), that will help control the pain level for a few minutes at best. Start using breathing control - regular, slightly slower than normal breaths to help keep it together. Yeah, it still hurts, but there are important decisions that can't wait for answers to be dealt with right now and this will help you get through it.

Where do you want to be taken?

If you are conscious, tell the emergency personnel your wishes. Ask for their advice if you aren't familiar with the area or are not sure about the severity of your injuries. Now what about cases where you are NOT conscious or coherent?

Your wallet should have your I.D. in it, and the police and paramedics need information. Secure an old business card in your wallet where it can be easily found that has ICE wriiten on it in big letters (In Case of Emergency).  Put your emergency contact person's phone number on it and your wish to be taken to a trauma center if at all possible.  Remember, you're a motorcyclist: it's not a matter of IF you will crash, merely a matter of WHEN.   It took me 38 years, but it happened.

What about towing the remnants of your bike/car?

Ask the police to inform you of where it is going and for them to provide a phone number and address if available. The tow truck driver can also leave a business card with you or the police.  There are daily charges for impound and storage that you insurance may or may not cover fully.

Speaking of insurance...

Have your ICE person contact the insurance company if you are not in any condition to call Sooner is better than later. Once your people know you are on the way for treatment is the perfect time to call. If they have come to the scene, they can get business cards or at least phone numbers to contact all concerned parties.

Motorcycle insurance is not required in all states, but I highly recommend it none the less. Health and disability insurance are also nice to have, since the bills can easily exceed $100,000.00 for a two or three week stay in the hospital. Check your policies to see if you have personal injury protection and gap coverage if you're making payments. The bank wants their money and doesn't care if you are broken into little pieces.Check around and price shop for decent coverages, it will be worth the effort should you ever need it.

OK, now it's really starting to hurt !

When someone who has had severe pain episodes tells you that it is necessary to be ahead of the curve, listen to them. Waiting too long, until the pain become intense actually makes it a lot more difficult to get back under control. Paramedics may or may not be able to give you something for pain. If not, do you best to try to relax, breathe, and think about the most pleasant place you've ever been in your life, the most pleasant experience, etc. Take your brain away from the pain - it really can help.

Being moved around - Hey, be careful!

Broken bones hurt when they are twisted, so keep emergency responders informed about where you are injured to minimize that problem. Splints help, but aren't perfect at immobilizing limbs, especially when you are lifted and moved from gurneys and exam tables. Watch out for three person lifting teams if you weigh more than 180 lbs. as I do. A fourth person may be needed to move you carefully enough to avoid major pain.

At the hospital emergency room.

The doctors and nurses will probably come around and ask you, " On a scale of 1 to 10, 10 being the worst pain imaginable, what is your pain level right now?".

Tell them honestly where it hurts and how much pain you are feeling. Depending upon your types and levels of injury, you may not get much pain relief right away. The pain medications can have bad side effects that could interfere with treatment and your ability to breathe, so hang in there as long as you can against the throbbing. Nothing they can give you will take away all of the pain and allow you to be awake, and they have a million questions to be answered again and again. Once they get all the the answers they need, you will probably be given enough pain meds to allow you to drift off to sleep.

Staying Positive 

Keeping as positive a frame of mind as you can is probably the best thing you can do to aid in your pain level control. You may not be able to walk or even get out of bed, but you can try a variety of mental routines to distract yourself from the pain. It can really work. For a few minutes, riding in the back of the fire department aid car, the small scrape on my pinkie hurt worse than the leg broken into eight pieces. I had been talking to the paramedic about my bike and had become angry again at the jerk who caused the crash. Probably not the best sort of distraction, hey, it worked!

Next up in the series - What Is a Trauma Center?

Dave from Shoreline

Required Reading For Pain Sufferers: The Pain Chronicles (A Book Review)

The Pain Chronicles by Melanie ThernstromPublished in 2010, Melanie Thernstrom’s book “The Pain Chronicles” covers the many aspects of pain in near-encyclopedic detail. Despite its staggering range of information  the book manages to connect on a personal level with narratives scattered throughout. None less touching than the author’s personal 12 year struggle with chronic pain.

The book was conceived by the author, who, as a journalist and a pain sufferer wanted to shed light on the topic at large. She proceeded to spend years experimenting, investigating causes, treatments, interviewing patients and observing some of the top pain doctors in the United States.  The results are depressing, hopeful, and thought provoking all at the same time.

The book is broken down in 4 basic components: pain as a metaphor, pain as a disease, pain as a narrative and pain as a perception. Each of the four sections is segmented out into mini-chapters; many of which pack the punch of scientific text coupled with poetic eloquence.

Thernstrom takes the reader on a tour of the cultural history of pain, reviews countless scientific studies and gives faces some of her statistics. She successfully navigates the necessary sensitives of writing on book on pain while managing to not sugar coat. To describe the book as comprehensive is an enormous understatement.

Whether you are chronic pain patient or not the book is highly engaging. The meticulous research and well formed prose provide an excellent backbone, but the true character of the book is revealed in the writing about the people. There are so many thoughts, fears and experiences splashed throughout the pages its difficult to wrap ones head around. Despite the many reasons for hope there are few perfect outcomes and even fewer certainties. As Thernstorn writes: “pain brings out the best or worst in people. . . . We write about pain, but pain rewrites us.'' 

Written By: Colin

Pain From Injuries Caused By Car Accidents Motor Vehicle Accidents

Pain Caused By Car Accidents and Motor Vehicle Accidents, Photo from Cool Valley on Flickr.com Hi , this is Dave from Shoreline, WA and I'm kicking off my experiences with Pain and Injuries from Car Accidents and Motor Vehicle Accidents.

Last year, I had a motor vehicle accident that fits the profile for the type of injury I sustained to a "T".  Age: 50+, male, married, tibial plateau fracture, motorcycle incident.

The first mini-bike I rode was in the 1960's, then dirt bikes in the 70"s, and street bikes from then on , up to August 2010. This wasn't a midlife crisis motorcycle purchase as some of you may have been thinking.

What an adventure these last seven months have wrought. Rides in fire department aid cars, ambulance rides, multiple surgeries, and five months (and counting!) of physical therapy. It seems limitless in thrills and chills, although I don't recommend it to thrill seekers or anyone else,

There will be a series of blogs that will hopefully offer helpful tips on what to expect from surgeries and therapies such as mine, so that you can learn from my mistakes without the painful lessons I learned.

We will cover things like:

• My Accident in Painful Detail
• You've Crashed, Now What? (Things To Do After The Crash)
• What is a Trauma Center and Why Should I Care?
• Pain Management - Team Approach During and After the Hospital
• Family Affair - You Will Need Help

New and/or Alternative Treatments for Pain and Other Issues

I look forward to sharing my continuing saga in the coming year and wish you the success I've had in dealing with one of the most painful injuries imaginable.

Dave
Shoreline, WA

Written By: Dave

Live Knee Replacement Surgery Online

Knee pain and joint pain are two of the most common types of pain in the country, particularly in people over the age of 60.

There are more than 500,000 knee replacement surgeriesconducted each year according to the American Academy of Orthopedic Surgeons.  In fact, in my family alone, there have been 4 knee replacement surgeries in the last six months.  Every knee replacement surgery was conducted on a woman in our family between the ages of 60-70.

Tomorrow Tuesday March 15, 2011, from 7AM to 12PM PST, Swedish Hospital in Seattle, WA will be conducting a knee replacement surgery on a 70 year old patient using robotic technology and BROADCASTING IT LIVE over the web.  In fact, people at home will be able to ask questions of the surgeons via the online chat and Twitter.  Amazing.

Click here to see the learn about knee pain, knee replacement surgery, and see the live knee replacement surgery at Swedish hospital.