Israeli lesson for hospitals on trauma preparedness at KEM Hospital
Dr Ruvie Rogel, deputy CEO of Community Stress Prevention Center, Israel visited KEM Hospital on Friday July 29, 2011
We were amazed at the ability of KEM Hospital doctors who treat so many patients every day,” this compliment came from a trauma expert from Israel, a country that often sees attacks, who visited the civic hospital on Friday.
Dr Ruvie Rogel along with two doctors psychologist Dr Fortu Benarroch and surgeon Dr Miklosh Bala from Hadssah Hospital in Israel - was in the city to talk on ‘trauma preparedness’ and share their team’s expertise with city doctors.
The team took rounds of the hospital and even saw the ongoing treatment of 13/7 blast victims. “All we could think was that the doctors here are handling a large number patients and still doing a commendable job,” said Dr Rogel, who is the deputy CEO of the Community Stress Prevention Center, Israel.
Psychiatrist Dr Rogel feels the city hospitals need to do a lot so as to effectively deal with mass casualty situations. Currently, over 10,000 patients visit the 1800-bed KEM Hospital every day.
Dr Rogel has worked extensively in Haiti after the earthquake, in Sri Lanka and Thailand after the tsunami and Mississippi after Hurricane Katrina. “There are several good things in this city. Now the authorities should build up on those good things and become better,” he said.
Speaking to Mumbai Mirror, Dr Rogel offered pointers that are must during mass casualty.
First and foremost, it is important for the hospital staff including the doctors to have a well defined role. The hospital should be well organised and the staff should know their work area during the time of emergency to avoid chaos. Here one can see nurses, ward boys and resident doctors crowding around one patient while another lies in pain.
Well developed interface
A well developed interface must be in place to help hospital coordinate with other agencies like the police, fire brigade etc during a trauma situation. “For a city like Mumbai, it is all the more important to have all these agencies in loop,” stressed Dr Rogel.
He also pointed that since Mumbai lacks such an interface, the victims reach late to the hospital. Echoing Mumbaikars’ concern during the 13/7 blasts, he said the way injured are brought to hospital is improper. There should be fleet of ambulances with stretchers on which the victims should be carefully carried to the hospital he said.
Good triage system
Victims should be sorted out based on the nature of their injuries. During a mass casualty situation, a doctor cannot afford to spend much time on dead (non breathing) victims who are termed ‘black code’. The medicos should first cater to the red code (grievously injured), then to the yellow code (serious injuries but stable) and lastly to the green code (minor injuries). He pointed out that in the recent blasts, the victims were rushed to hospitals and all of them were admitted to the emergency ward. There was no segregation of the victims.
A message to netas?
Management of the crowd is a must to avoid chaos. This ensures that the attention is always on the injured and not the others who gather inside and outside the hospitals.
Focus on psychosocial element
Dr Ruvie Rogel
More than the bleeding wounds, the mental trauma is more deadly. Just imagine a person who was doing well in his career, had a happy family life and one fine day he injures himself in a terror attack and loses a limb. If the psychosocial element is not taken care of, the victim will never recover completely from the trauma of an attack.
Take care of the caretakers
Constant interaction with the dead and injured affects the caretakers of the victims that include the doctors, nurses and other hospital staff. Their efforts should be acknowledged and they should be allowed to rewind after the emergency situation is brought under control. Something like this has never been done in Mumbai so far.