SAN FRANCISCO (KCBS) — Right inside the ambulance bay at San Francisco General Hospital is Zone 1 of the Emergency Room. This is where all the gunshot, stabbing and high-speed car crash victims end up.
In July, when Asiana Flight 214 crashed at SFO International Airport, over 60 victims were treated at the hospital’s trauma center. It’s one of the city’s 11 emergency rooms and is the main trauma center.
New Year’s Eve tends to be one of the busiest days of the year and the number of trauma cases could triple. KCBS reporter Holly Quan spent a night with the doctors and nurses at SF General for a special report.
At 7 p.m. on a Friday night, Charge Nurse Shino Honda already has more patients than beds.
“I think right now we have close to 50 patients. This is a 27-bed E.R. We are already at capacity with twice more than we can handle and we’re doing it. All my nurses are working really hard,” she said.
The Emergency Room sees patients with high-risk pregnancies, broken bones, and illness, but that’s just the tip of the iceberg.
“We have patients with pretty bad pneumonia that have to be intubated because it’s hard for them to breathe. And then we had a patient who fell [with] head trauma. And then there was that unusual diagnosis of a fishbone in the throat.”
Honda explains how their facility is equipped to do a scope to see where the fishbone is.
“We have all the services because we’re a Level 1 trauma center, which means we have to have all the specialty doctors on call or on site right away.”
After explaining an ear, nose and throat doctor needs to be on hand at all times, she runs off to answer a special phone that rings when an ambulance is on the way.
SF General gets 30 percent of all ambulance calls in the city. This one brings a victim of a high-speed car crash. Dr. Eric Isaacs is one of two attending physicians.
“The young man who was the driver of a high-speed crash where he rear-ended a car on the freeway: his main complaint is chest pain. It hurts a lot when we palpate his chest or push on his chest,” he said.
Sometimes the most serious injuries aren’t the most obvious.
“You’re traveling at 65 miles an hour and suddenly stopping and the fact is that this ligament just holds part of the aorta, so part of the contents of the body move forward and part of the aorta’s held still and it just sort of tears. It’s a pretty unusual injury, but it’s a lethal injury so we need to think about it. That’s going to be our main focus,” Isaacs said.
The young man was the 5th trauma patient in three hours and the night was still young.
“This is very typical for us. High-speed motor-vehicle crashes, falls off of ladders,” Isaacs said before being interrupted by another important call.
More people dash off into Zone 1 where at 9:50, a surge of trauma cases arrived. A juvenile girl is unresponsive. Hospital staff can be heard telling her to wake up and open her eyes.
A man with a head injury acts erratically while a gunshot victim shows up at the ambulance bay.
Another attending physician, Dr. Craig Smollin said it’s the worst kind of situation when patients show up on their own rather than in an ambulance since they don’t get any warning when people simply show up. Still, they remain prepared.
“At least when they come by ambulance we know they’re on their way, we can mobilize our team and all be ready and prepared for them to come in,” he said.
The gunshot victim is wheeled to a secure room where he’s followed by law enforcement. The erratic man was being checked for drugs and other complications.
“Believe it or not I’m not as worried about the gunshot wound because it’s to his extremity. I’m more worried about the guy who was banging on the cars because maybe he has bleeding in his brains, so we’re sending him over for a CAT scan of his brain and his neck to make sure he doesn’t have any fractures or anything in his brain,” Smollin said.
Within 20 minutes the team took in four trauma cases.
“So that’s what we do. We juggle balls here and if we do our jobs right, none of them fall on the floor.”
Oftentimes these are life and death situations; so who wants to work in this pressure cooker of a workplace? We’ll explore that angle in part two of our special report.
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