Hospitals looking out for snow-related injuries

Unaccustomed activity can trigger illnesses, accidents

February 12, 2010|By Kelly Brewington | kelly.brewington@baltsun.com

Just as hospitals are replenishing their staffs and playing catchup after back-to-back snowstorms, they're bracing for another emergency: an onslaught of patients with snow-related injuries.

During bad weather, emergency-room volume takes a dip. But once the snowbound emerge from their homes, they tend to overdo it, shoveling too much, driving on unsafe roads and aggravating existing illnesses that can land them in the ER. The result: cases that include children who hurt themselves sledding and adults with broken bones and head injuries from falling on icy streets.

"In the [emergency room], now the concern is for people's safety," said Kathy DeRuggiero, director of nursing for emergency medicine at Johns Hopkins Hospital. "People will get out and do things they're not used to doing. Patients with underlying cardiac conditions and with underlying respiratory conditions end up exerting themselves more than they would in a normal day. … People are tired of being inside; they want to venture out."

For cardiac patients, such activity can trigger a heart attack.

"Shoveling's a lot of work," said Dr. Benjamin Vanlandingham, an emergency department physician at St. Joseph Medical Center in Towson. "You go out there and do this intense exercise. That's a classic precipitating event for a heart attack."

The take-home message: Slow down, be careful on slick streets and don't go beyond your limitations, he said.

With the low temperatures and some homes without power, hypothermia is also a concern, said DeRuggiero.

And then there's everything else. People with problems that include bladder infections and stomach pains, patients with chronic illnesses, such as those on dialysis who have been unable to make it to treatment centers during the storm but are now seeking care.

While hospitals are built for emergencies, two storms and a crush of new patients is challenging to staffers who have already worked long hours.

"We've had more than 20 ambulances today, and they're coming in two, three, four at a time," said Michael Schwartzberg, a spokesman at Greater Baltimore Medical Center. "A lot of the nursing staff at the ER are folks who worked days and days. They went home to get some rest. But we can't even call extra staff because there's no one to call."

At GBMC and other area hospitals, some staffers showed up early for shifts and stayed late, camping out at the hospital for up to four straight days. At Hopkins, about 1,100 staff members were housed at the hospital along with a heavy patient load - 85 percent full, said DeRuggiero. Making sure everyone had enough linens, food and a place to sleep was a huge undertaking in itself, she said.

At Baltimore's Sinai Hospital, emergency room patients who came through during the storm weren't discharged into blizzard-like conditions. So they stayed overnight at the hospital. Now, staff is trying to make room for an anticipated increase in patients.

"Because patients were not able to get home after being discharged, we were extremely taxed. That made it difficult to work as efficiently as we should," said Diane Johnson, vice president of patient care services and chief nursing officer at Sinai Hospital.


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