Sixty minutes, a “golden hour.”
That’s about all trauma victims have before the damage they suffer during a disaster, such as the train-school bus accident on Wednesday, progresses to a point that recovery is impaired, treatment complicated and prognoses made grim.
And that is why logistics and life merged inextricably in the crucial minutes following Wednesday’s crash.
The Fox River Grove paramedics, first on the scene, arrived within minutes of the early morning crash. They acted as choreographers, orchestrating about 16 fire departments, seven hospitals, numerous ambulance services and several medical helicopters.
Within 30 minutes, the most seriously hurt were speeding to trauma centers where hospitals, which called in reinforcements, were waiting. The less seriously injured received some treatment at the scene before being loaded onto ambulances that were just minutes behind the earliest arrivals, while the walking wounded were the last to go.
“Trauma patients have a golden hour-one hour-from the time of injury for doctors to get working on them and pull them together,” said Patrick Finnegan, director of clinical, administrative, professional and emergency services for the Metropolitan Chicago Healthcare Council, a group of Chicago-area hospitals and health-care organizations.
“If they’re going to save a patient, bring him back to as normal a life as he’s going to get, they can do that if they get the patient to a facility as quickly as possible,” Finnegan said.
For example, in an injury in which the chest fills with blood, that blood can act like a vise around the heart. In roughly an hour, the heart is choked off and becomes unable to pump blood, causing death.
In every area, one local hospital is designated as a resource hospital or command-post hospital that will coordinate response after an emergency and work with the paramedics on the scene. In Wednesday’s case, that responsibility fell to Northern Illinois Medical Center in McHenry. Officials there contacted other area hospitals to determine such things as available beds, blood supply and other medical factors to sort out which victims should go where.
Those considerations are factored into the severity of the injuries that victims seem to display.
“When you have a high number of serious patients, you want to send the ones who are most injured to the closest hospital,” said Dr. George Gallant, a physician at Northern Illinois Medical Center who coordinates emergency medical response for McHenry and western Lake County.
“You also want to disseminate a wide variety of serious and moderate and minor injuries to somewhere else,” Gallant said. “No one hospital should have been totally overwhelmed. That will give the patients the best chance of survival.”
The timing of the accident made it possible for hospitals to keep their night-shift people overtime, to double their staffs easily and quickly, Gallant said.
That was the case at Good Shepherd Hospital in Barrington, which received 10 victims.
“We had more than 25 emergency trauma and other specialist physicians that we called in, and more than 50 nurses,” said Cheryl Smith, a hospital spokeswoman. “Many of them stayed from the night shift.”
Within about 75 minutes of the crash, every victim had been treated somehow and taken somewhere.
As the final act in the tragedy, the paramedics and emergency teams left, and the safety investigators moved in.
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