Mumbai & other event observations

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Dr. Mattox, et al.

Information about the I-35W bridge collapse in Minneapolis can be found in
Hick, John L. MD; et al. Hospital Response to a Major Freeway Bridge
Collapse. Disaster Medicine and Public Health Preparedness. Vol. 2 Supp 1
pS11-s16.

I am third year EM resident at Hennepin County Medical Center, the closest
trauma center to the bridge collapse, and was a minor author on the above
paper.  I have an interest in disaster preparedness and response and would
be happy to share my experiences of the event.  Feel free to contact my
offline at mclark911 at gmail.com
 -----
Michael Clark, MD
Emergency Medicine Resident, Class of 2009
Hennepin County Medical Center
Minneapolis, MN

 Medical Director
Special Olympics-Wisconsin

651-263-4850 Cell
612-336-0493 Pager

 "Medicine is the only profession that labors incessantly to destroy the
reason for its own existence." --James Bryce
 "Whoever wants to become great among you must be your servant, and whoever
wants to be first must be slave of all." Mark 10:43-44
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 On Thu, Nov 27, 2008 at 6:22 PM, <KMATTOX at aol.com> wrote:
>
> 1.    Every since Allison, Katrina, and Ike, I have been  pondering the
> issues of (TRAUMA) surgeon's role in disasters, particularly one  like we
have just
> witnessed in Mumbai.   I have watched disasters the  past 5 years have 4-5
> doctors and an additional 4-5 nurses per patient with more  than 85% of
the
> disaster causalities at the trauma center having extremely minor
 conditions.
>
> 2.    I do believe that the issue of SURGE has been both  UNDER and OVER
> emphasized.     It is poorly  understood.    I am very curious as to what
the real
> surge was at  Charity in New Orleans, at the major hospital in
Minneapolis,
> at the designated  trauma centers in Washington DC and NYC during 911,
during
> the fires in  California, at Parkland during Katrina,   In San Antonio,
 etc.
>  In the USA, except for a stressful Friday night in  the ER, we have not
> really experienced Disaster Surge.
>
> 3.   Despite the rhetoric, we in the USA have more lectures  about SURGE,
> than we have had experience.
>
> 4.   In Mumbai, the very few trauma centers certainly has  significant
SURGE
> with their more than 300 blast and GSW victim, although, I  calculate the
24
> hr surge there to be less than 25 patients, making the CITY  WIDE surge
only
> 1/hr if my calculations are correct.
>
> 5.  I would like to chat off line with the few persons in the USA (and
> outside if really experienced and interested) who have had experience with
large
> simultaneous experience with penetrating trauma, other than the "busy
Friday
> and  Saturday night".   I would request that interested persons contact me
> (_Kmattox at aol.com_ (mailto:Kmattox at aol.com)  )  or Dr. Norman  McSwain  (
> _nmcswai at tulane.edu_ (mailto:nmcswai at tulane.edu) ) of your interest and
 experience.
>   I have a couple of hypotheses I would like  to discuss with those who
have
> really really been there.
>
> 6.    Recall that ALL TRAUMA DISASTERS are  LOCAL.     This is a time for
the
> kind of interactive  collaborative networks that we see in Connecticut,
> Texas, and  elsewhere.   It is the kind of network which was headed by Dr.
Ron
> Stewart for the 5 state ACS Region VI during Katrina and Ike.   That
 worked like
> a charm.
>
> 7.    After a great deal of reflection and analysis, I am  also about
ready
> to give strong recommendation that the entire OUTSIDE Physician
 assistance
> response for TRAUMA disasters be totally reanalyzed, rethought, and
 reorganized.
>  This includes:  DMAT, NDMS,  Rangers,  etc.   There are a significant
> number of problems with these concepts  and a number of areas that did not
work
> during the recent disasters in the  USA.   I would call upon the Disaster
> Committees of the AMA, AHA, ACS,  ACEP, and others to seriously honestly
look hard at
> what we all have learned  together the past 10 years about real time
MEDICAL
> DISASTER.   I am  not talking about evacuations, shelters, public health,
etc.
>    I'm talking about the first 24-36 hours.
>
> I look forward to hearing from a few good men and women who have been
there
> and done that.   I want to exercise your  brain.
>
> Kenneth L. Mattox, MD
>
> PS    Norm McSwain and I have already  chatted.    We do not have
solutions,
> we do have some questions  and observations.
>
> k
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