Savoir Faire: A management for mass causality

Vishnu C

Deputy Nursing Superintendent, Kauvery Hospital, Hosur

Correspondence: M: 9087030738; Email: [email protected]

The overview

One night, about 12 am, at a place called Kelamangalam near Hosur, a lorry and a company bus crashed head on, resulting in severe injuries to 32 members of the company’s workers who were sent to our hospital.

At 12:15am, my phone rang; I awoke to pick up the call, I heard that message” Mass Casualty at our hospital!

At that moment, my mental preparedness to attend to the patients was nothing, so I contacted my department colleagues to pass on the mass casualty information; they were enthusiastic to accompany me in treating those who are injured.

We headed towards the hospital, which was extremely crowded with patients and the attendants screaming vigorously. We came to the screaming scenario, and the tiredness vanished. We rushed into the department, and initiated the CODE YELLOW to pass on the message to all departments in the hospital.  Everyone received the message and came forward to the Emergency Department. Many staff from Housekeeping, Pharmacy, Radiology, Lab, and other health care departments also came to the ER department. Additionally, our unit General Manager, Medical Admin, Operational Heads, Consultants, Hostelers etc., came voluntarily.

Patients and attenders were emotionally and physically vulnerable at the scenario. We focused on treating every patient at the same manner; and everyone was emitting screams like “pain, pain, pain,” Some patients had massive bleeding and seepage. Attendees were urged to take care of their sons and daughters first. All the patients were of young age and mostly female employees only. We worried about their future.

We were determined to treat patients with significant injuries in the primary ER and lesser injuries in the Fever ER and OPD areas (triaging). Initially, we began to administer medications for pain relief and Tetanus vaccine to all patients. Antibiotics appropriate to patients’ conditions were started in the ER, and prompt care was provided.

At the time of Mass Casualty, an ANC mother arrived at the emergency for admission and other patients with fever and other sicknesses also came for treatment at the same time.

Doctors, Nurses, other health care worker came voluntarily to help at that time to handle patients as well as providing moral support to all.

Totally, we treated 32 patients in the Emergency, 10 patients were treated at OPD itself, 16 patients were converted to IP admission to treat at Ward and ICU based on the severity of Injuries. Priority based CT, X-ray were taken to start the treatment. Overall there was 50 CT and 53 X-rays were taken at within 1 hr at the time of mass casualty. The main thing was that no patient was referred to other hospitals, they were treated at our hospital itself. Initially, we segregated the patients Triage coding like green, Yellow, Red & Black.  Fortunately none were tagged Black.

 

Most patients were settled, by 4’o clock, and we cleared the CODE YELLOW. Case sheet, indenting work, Admission work, AR copy work, other system and writing work etc., were done at the time or after 4’o clock. Staff were coming on the morning shift, 1 hr early to the department to take  over handover and  began to assist in Medicine Indenting work, case sheet filling etc.,

After all the patients were settled, we felt proud being nurses. The hospital staff felt like a family, giving care to the patients who suffered Mass Casualty. Finally, all the patients were discharged successfully.

In our ECM meeting, our unit heads highly appreciated our work with his words.  We collected the post- discharge calls reports on status; patients were fine and healthy and they return back to duty.

Points to ponder

How Blessed we were!  We were able to help patients at the time of distress. We became the super heroes in their eyes. Not everybody gets the opportunity to help people at such times, but we got a chance to help. We felt like the bet nurses in the universe.

Savoir Faire is a French expression means – a knowing how to do

Mr. Vishnu C
Deputy Nursing Superintendent

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