by: Tara Grenier, M.Sc., CAT(C)

Most of us have been cramped up inside for weeks now. Few are still venturing out. As an Injury Prevention Professional, I look at these strict social distancing measures from a slightly different perspective – a trauma perspective. So let me explain why being more vigilant both inside and outside your home is more important now than ever.

Avoiding a health care system overload

With Covid-19 cases on the rise, the health care system is under a tremendous amount of pressure.  Health care providers are being reassigned. Some non-urgent care and surgeries are being postponed. All efforts are put in place  to mitigate the risks of infection and to ensure that equipment, such as ventilators, will be available for severe Covid-19 cases.

Sure, the Trauma Team at the Montreal General Hospital is still ready to respond to injuries. However, in the current pandemic, you may want to think twice before engaging in an activity that could lead to a trauma.  Consider this: despite the fact that great efforts are being taken to isolate infected patients, being treated at a hospital puts you at a greater risk of catching Covid-19. Don’t forget that some patients may be asymptomatic and spread the virus to others, unknowingly.

Preventing preventable traumas

The risk of car crashes is greater the more there are cars on the roads. The risk of pedestrian injuries also increase proportionately to the number of people walking around.  And as the bicycles and motorcycles come out of hibernation, the potential for collisions also increases. That is why we don’t need to be out and about on the roads when it’s not essential.

The idea is twofold : to avoid putting additional pressure on our healthcare system by taking unnecessary risks that might lead to traumas, and to limit the spread of the virus, including to our very essential hospital staff, by avoiding unnecessary hospital visits.

Limited Resources

We have a limited number of Trauma Surgeons on staff, along with a few Fellows and a few Residents, in spite of being a Level-1 Trauma Centre responsible for the care of patients from Montreal (south of autoroute-40), the Monteregie and the Northern Territories. Should they become ill, our capacity to care for our trauma patients decreases significantly.  We also have a limited number of neurosurgeons who respond to traumas. Again, if they become ill, our capacity to treat brain injuries becomes limited.  The same is true for our other health care professionals such as Nurses, Nurse aids, Respiratory Therapists, Pharmacists, Technologists and others who work with trauma patients.

Sure! Contingency systems are in place to have the General Surgeons take on the role of the Trauma Surgeons.  But  keep in mind that Trauma Surgeons, in our case, are General Surgeons who do an extra year of training, not to mention they have years of work experience with trauma patients.  Similarly, our Neurosurgeons who specialize in trauma have a tremendous amount of experience doing damage control cases.  Many other health care professionals have also been trained to work with trauma patients. So yes, they are all technically replaceable by other professionals in other departments… but at what cost?

What we don’t want to see happen

Eventually, if the patient load surpasses the system’s ability to adequately care for the patients, we would be in a scenario similar to Code Orange.  This happens when mass casualty occurs, such as in a bus crash or a train wreck. Unfortunately, when this happens, difficult choices must be made : patients with minor survivable injuries are given less attention, while resources are focused on patients with severe yet survivable injuries.  The very severely injured patients who show little promise of recovery may go untreated or offered very minimal resources until more become available again.

In the current pandemic, if the health system becomes overloaded, doctors will have to take decisions on who to save : do they give the limited number of ventilators to young patients with many potential years ahead of them or to seniors with potentially less years ahead? These are questions no health professional wants to answer. And they won’t have to if we all lighten their load by taking precautions to limit traumas and injuries.

So for their sake and yours, stay home and off the roads! Read my other tips on how to limit injuries and stay safe while stuck at home.

Meanwhile, should you need medical attention for injuries you sustain, do not delay. All the necessary precautions will be taken to keep you safe and provide you with quality care.

 

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