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Code orange: ‘Human tragedy’ of fatal bus crash tests staff at Ottawa Hospital

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It didn’t take long for staff at the Ottawa Hospital to learn something terrible had happened at Westboro station late Friday afternoon.

After initial reports started trickling in through social media about a double-decker OC Transpo bus crashing into a bus shelter, officials called paramedics to find out what, exactly, was going on.

Emergency responders confirmed there had already been fatalities and asked hospital staff to prepare for the incoming wounded.

“When they were able to confirm that we had at least five critical patients that would be coming, and possibly over 12, that’s when we made the decision to call the code orange,” said Dr. Guy Hébert, the head of the Ottawa Hospital’s emergency medicine department, who was on duty that day.

In the end, the hospital treated 18 patients — 12 at the Civic campus and six at the General campus.

“We were indeed able to confirm that that was the largest number that we had ever received,” Hébert said.

Another look at the damage after Friday’s crash. (@karinawieser/Twitter)

At the moment the code orange was declared, the Civic campus was already treating 100 patients, 24 others had been admitted and were waiting for beds, and the waiting room was busy.

A typical trauma centre can handle about three to four seriously injured patients at any given moment, but doctors knew that this time, there would be more.

“We knew bad things were coming in, and we were getting ready to work together to save lives,” said Dr. Andrew Willmore, the Ottawa Hospital’s medical director of emergency management, who was in Texas for a conference when the crash happened.

Accommodations had to be made, and fast.

The Ottawa Hospital called a ‘Code Orange’ on Friday to get all hands on deck to treat patients from the bus crash. 8:23

Resuscitation bays cleared

“What a code orange does is it allows us to create the space in which we can actually treat patients. We move patients and clear our resuscitation bays,” Willmore told CBC Radio’s Ottawa Morning on Monday.

“It realigns the way the hospital functions to really support the emergency department, and rapidly increases the number of staff available to look after patients.”

By about 4:20 p.m., the Ottawa Hospital had eight resuscitation bays fully staffed and ready for treatment, with as many as 150 medical staff standing by, waiting to snap into action.

Dr. Andrew Willmore of the Ottawa Hospital said staff declared a code orange not long after a double-decker OC Transpo bus slammed into a Westboro station bus shelter on Friday, Jan. 11, 2019. (Ashley Burke/CBC News)

Paramedics called the hospitals in advance, letting them know the age of each patient, their injuries, vital signs and estimated arrival time.

“As they rolled through the door, we were able to immediately assign them to a trauma team. Every single patient that came through our doors were immediately, within the first 15 seconds, at the bedside, surrounded by a dozen people to begin the assessment and treatments,” Hébert said.

Cases involved ‘every organ system’ 

Every patient was dealing with blunt-force trauma, Willmore said.

“With the speed at which the bus collided, it affected pretty much every organ system in these patients. From head to toe, there were multiple injuries and multiple different organ systems affected in each one of those patients,” he said.

There were head injuries, chest injuries, pelvic injuries, abdominal injuries, spinal injuries and “a whole slew of different kinds of … injuries to the arms and legs,” Hébert added.

Some amputations had to be performed, he confirmed, and the hospital quickly exceeded its supply of special equipment to treat limbs. Other hospitals stepped in to lend what was needed.

“This is something that we’ve rehearsed before. We have regular training to prepare for these kinds of events. We’re no strangers to difficult situations … but this is something that we don’t deal with on a regular day-to-day basis, so there was definitely a level of intensity to the initial preparation of this,” Willmore said.

As of Monday morning, every patient in critical condition had been upgraded to serious or stable condition, but the work isn’t over yet.

Many patients have required additional surgeries, Willmore said.

Flowers and cards are being left at Westboro station after Friday’s crash. One of the handwritten cards reads, ‘Words are not enough, but you are in our thoughts + prayers.’ (David Richard/CBC)

As the dust settles at the hospital, those involved in Friday’s response have time to reflect.

“It’s afterwards, when it all sort of sinks in, when the human side of things start to hit us, start to hit home, there’s no question that what we saw was quite graphic and quite heartwrenching. It can’t help but affect us in a significant way,” Hébert said.

“It makes us think about how fragile is life, and how an event like this can happen all of a sudden and be so life-changing. We as caregivers are naturally empathetic to that, and naturally we see this kind of human tragedy so often in our day-to-day, and it can’t help but impact us.”

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Health Ranger posts new microscopy photos of covid swabs, covid masks and mysterious red and blue fibers

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(Natural News) What follows is a series of microscopy photos of covid swabs (a synthetic swab, then a cotton swab), a covid mask and some zoomed-in photos of mysterious red and blue fibers found in the masks.

The magnification range for these photos is 50X to 200X. Most were taken with white light, but several (as indicated) were taken with UV light.

The images shown here are 600 pixels wide. We have higher resolution images available to researchers and indy media journalists; contact us for those hi-res images.

More microscopy investigations are under way, and new images will be posted as they are finalized.

First, this series shows the carbon fiber layer of a covid mask, illuminated with UV light:

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5,800 test positive, 74 die of coronavirus at least 14 days after getting fully vaccinated

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(Natural News) The Centers for Disease Control and Prevention (CDC) on Thursday, April 15, confirmed some 5,800 breakthrough coronavirus (COVID-19) cases in the U.S.

A breakthrough COVID-19 case is defined as someone who has detectable levels of SARS-CoV-2 – the virus that causes COVID-19 – at least 14 days after getting fully vaccinated against the disease.

Nearly 400 breakthrough cases required treatment at hospitals and 74 died. A little over 40 percent of the infections were in people 60 years and above and 65 percent were female. About 29 percent of the vaccine breakthrough infections were reportedly asymptomatic. The figures were for cases through April 13.

CDC Director Rochelle Walensky told a congressional hearing on Thursday that the causes of the breakthrough cases are being probed. “Some of these breakthroughs are, of course, failure of an immune response in the host. And then some of them we worry might be related to a variant that is circulating. So we’re looking at both,” she said.

The CDC is monitoring reported cases “for clustering by patient demographics, geographic location, time since vaccination, vaccine type or lot number, and SARS-CoV-2 lineage.” It has created a national COVID-19 vaccine breakthrough database, where state health departments can enter, store and manage data for cases in their region.

Where available, respiratory specimens that tested positive for COVID-19 will be collected for genomic sequencing “to identify the virus lineage that caused the infection.”

Positive test less than two weeks after getting fully vaccinated is not a breakthrough case

The number of cases the CDC has identified does not include people who contracted COVID-19 less than two weeks after their final dose. The two-week marker is important, said infectious disease expert Dr. Amesh Adalja, senior scholar at the Johns Hopkins Center for Health Security.

A human body should have enough time to develop antibodies to SARS-CoV-2 after that timeframe. Before then, a person won’t necessarily have the built-up immunity needed to fight off an infection. According to Dr. Adalja, cases that occur before the two-week mark are not considered breakthrough cases.

Dr. Adalja also noted that more research is needed to determine if highly infectious variants of the virus are behind the breakthrough cases. “It is crucial to study breakthrough cases to understand their severity, their contagiousness and what role variants may be playing,” Dr. Adalja said.

More than 78 million people have been fully vaccinated against COVID-19 in the U.S. as of April 15.

“To date, no unexpected patterns have been identified in case demographics or vaccine characteristics,” the CDC said in a statement. “COVID-19 vaccines are effective and are a critical tool to bring the pandemic under control.”

But the CDC conceded that “thousands of vaccine breakthrough cases will occur even though the vaccine is working as expected.”

Dr. William Schaffner, an infectious disease specialist and professor at the Vanderbilt University School of Medicine, agreed with the CDC. “These vaccines that we’re using are fabulous but they’re not perfect,” he said. “At best, they’re 95 percent effective in preventing serious illness, but minor illnesses can occur.”

According to U.S. drug regulators, Pfizer’s COVID-19 vaccine is 95 percent effective in preventing infection. Moderna’s was shown in a clinical trial to be 94.1 percent effective while Johnson & Johnson’s was 66.9 percent effective. Only Johnson & Johnson vaccine, which received its emergency use authorization from the Food and Drug Administration (FDA) on Feb. 27, was tested when variants were circulating.

The percentages are based on results from vaccine recipients two weeks after the final vaccination.

Dr. Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases, stated in a briefing last week that the breakthrough cases are not a cause for concern.

“I think the important thing is to look at what the denominator of vaccinated people is. Because it is very likely that the number of breakthrough cases is not at all incompatible with the 90-plus percent vaccine efficacy,” he said. “So I don’t think that there needs to be concern about any shift or change in the efficacy of the vaccine.”

More info needed before drawing conclusions from breakthrough cases

The percentage of vaccine breakthroughs in a population depends on multiple factors, including vaccine efficacy, the amount of virus circulating and the length of time since vaccination, according to Natalie Dean, an assistant professor of biostatistics at the University of Florida.

“I love to see small numbers as much as anyone, but know that numbers like this cannot be directly interpreted as a measure of vaccine efficacy (although I have a feeling they will be). We can only interpret them against a background rate in unvaccinated people,” Dean wrote on Twitter.

“Similarly, ‘most breakthroughs have been in elderly adults’ should not be read as the vaccine is less effective in elderly adults. The majority of vaccinations (and the longest amount of follow-up time) have been in elderly adults. Again, we need more info to interpret.”

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More people died from fentanyl overdose than coronavirus in San Francisco last year

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(Natural News) More people died from fentanyl overdose than coronavirus (COVID-19) in San Francisco last year, a microcosm of a larger nationwide problem coinciding with the pandemic.

Data from San Francisco’s Office of the Chief Medical Examiner shows that 708 people were killed by fentanyl in 2020, an astonishing 118 times more since the introduction of the drug in the city just five years earlier.

That figure nearly tripled the 254 COVID-19 deaths recorded in the city for the whole of last year. More than 8 in 10 deaths were male, and just under half were white. People aged 55 to 64 made up nearly a quarter of the fatalities. Nearly 40 percent of the deaths occurred in open-air drug markets such as the Tenderloin and South of Market.

The number of overdose deaths in the city could have been far worse as more than 3,000 addicts suffering from an overdose were administered with naloxone, the lifesaving medication that reverses overdoses.

San Francisco’s death rate from fentanyl overdose continues to rise this year as 135 died by overdose in January and February, putting the city on pace for more than 800 deaths by the end of the year.

The city has become a significant part of a larger trend. The Centers for Disease Control and Prevention (CDC) released data on Wednesday, April 14, showing that more than 87,000 Americans died from drug overdose over the 12-month period that ended in September last year – the highest since the opioid epidemic began in the 1990s.

Lockdowns lead to more cases of drug overdose

The surge represents an increasingly urgent public health crisis that may be correlated to the government’s monotonous battle plan against the COVID-19 pandemic.

On March 19 last year, California became the first state in the U.S. to implement a stay-at-home order. It subsequently endured the longest lockdown of any state in the country.

The pandemic and accompanying lockdowns are believed to be partly responsible for the soaring number of drug deaths for obvious reasons. Lockdowns have badly disrupted the social services in the city, including drug addiction treatment. Drug experts say the isolation of the past 12 months is causing vulnerable residents to turn to opioids.

“We see the death and devastation getting worse right in front of us,” said Matt Haney, San Francisco Board of Supervisors member. “It’s an unprecedented spiraling, directly connected to the introduction of fentanyl in our city.”

Fentanyl first appeared on the streets of San Francisco in 2015. There were just six deaths from the synthetic opioid that year, 12 deaths in 2016 and 37 deaths in 2017. The figure skyrocketed when the drugs became widely available in the city in 2018.

Kristen Marshall, manager of the national drug harm reduction DOPE Project, noted the grim irony that while social isolation could save lives from COVID-19, it had undoubtedly contributed to the number of overdose deaths.

“Isolation is also the thing that puts people at the absolute highest risk of overdose death,” she said.

Pandemic exacerbates rise in deaths from drug overdose

The number of deaths from drug overdose started rising in the months leading up to the coronavirus pandemic, making it hard to gauge how closely the two phenomena are linked. But the pandemic unquestionably exacerbated the trend. The biggest jump in overdose deaths took place in April and May when fear and stress were rampant, job losses were multiplying and the strictest lockdown measures were in effect.

Many treatment programs closed during that time while drop-in centers, which provide support, clean syringes and naloxone, cut back services.

The data released by the CDC shows a 29 percent rise in overdose deaths from October 2019 through September 2020 compared with the previous 12-month period. Illicitly manufactured fentanyl and other synthetic opioids were the primary drivers, although many fatal overdoses have also involved stimulant drugs like methamphetamine.

Unlike in the early years of the opioid epidemic, when deaths were largely among white Americans in rural and suburban areas, the current crisis is affecting Black Americans disproportionately.

“The highest increase in mortality from opioids, predominantly driven by fentanyl, is now among Black Americans,” Dr. Nora Volkow, the director of the National Institute on Drug Abuse, said at a national addiction conference last week.

“And when you look at mortality from methamphetamine, it’s chilling to realize that the risk of dying from methamphetamine overdose is 12-fold higher among American Indians and Alaskan Natives than other groups.”

Dr. Volkow added that more deaths than ever involved drug combinations, typically of fentanyl or heroin with stimulants.

“Dealers are lacing these non-opioid drugs with cheaper, yet potent, opioids to make a larger profit,” she said. “Someone who’s addicted to a stimulant drug like cocaine or methamphetamine is not tolerant to opioids, which means they are going to be at high risk of overdose if they get a stimulant drug that’s laced with an opioid like fentanyl.”

The Drug Enforcement Administration (DEA) supported Dr. Volkow’s claim, saying that transnational criminal organizations cause a spike in overdoses by mixing fentanyl into illicit narcotics.

According to the DEA, Mexican cartels often purchase the drug components in China and use human mules to smuggle the narcotics to lucrative drug markets north of the border.

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