Sept. 21, 2014 began as just another day in the Christiana Care Emergency Department, but all that changed when a tour bus with international tourists rolled over three times as it failed to a negotiate a local off-ramp.
A Code Delta page went out to all emergency providers at Christiana Care to signal a mass-casualty event. Rising to the occasion that day were 10 Emergency Department attending physicians, five trauma surgeons, a vascular surgeon, a neurosurgeon and an orthopaedic surgeon, who all responded within minutes. Christiana Care would receive 29 of the most critical trauma patients from this accident.
In November, Philadelphia hosted a regional day of trauma to highlight the most memorable cases from each trauma institution. Jason Weinberger, D.O., a fourth-year surgical resident, gave a thorough case presentation of a patient from this tragic accident.
“He did a fantastic job highlighting our lessons learned from this terrible disaster,” said Mark Cipolle, M.D., Ph.D., FACS, FCCM, medical director, Trauma Program at Christiana Care and professor of surgery, Sidney Kimmel School of Medicine, Thomas Jefferson University.
Dr. Weinberger began with photos of emergency responders assisting passengers at the bus and gave an impressively detailed PowerPoint presentation that earned top honors from a panel of judges at the 21st Annual Day of Trauma. The event was sponsored by the Trauma Directors of Philadelphia, a group that includes representatives from eight Philadelphia area hospitals.
“Jason was very thorough and presented in a fluid, engaging style,” said James Eakins, M.D., medical director of Trauma and Surgical Critical Care at Hahnemann University Hospital and a lead conference organizer. Dr. Weinberger told the story of a 43-year-old woman from India, who died with her family at her bedside, despite all efforts to help her.
The gratitude of the family touched Dr. Weinberger, who says he learned a great deal about the humanistic aspects of critical care.
“A big lesson for Christiana Care is that we are a large institution and there are many different small areas of expertise that we call on in a Code Delta,” Dr. Weinberger said.
At the Trauma Day event, Dr. Weinberger gave an account of a patient brought to the hospital who arrived with severe blunt trauma to her abdomen. Crying inconsolably when she arrived, she needed surgery to repair lacerations to her liver. She spoke no English, complicating the treatment of her injuries.
Despite initial improvement, she showed signs of worsening liver and heart failure after a second operation.
Fortunately by day five of her stay, her family arrived from India. They saw that everything was being done to save her.
“They were relieved that she hadn’t just died in a gruesome accident and that they could now offer their love and prayers,” Dr. Weinberger said. “Initially I thought of this case as a failure, but with time I could see that our work truly gave her loved ones comfort. All that we did for her was important. Our efforts had a role to play in helping the family make peace with what had occurred. She is a reminder that we cannot save every patient, but all our efforts are worthwhile.”