Be patient, victims of trauma

Photo: Toomas Huik

Hospitalised man sent home by taxi waits days for emergency surgery.

With part of hospital staff having summer holidays and traumas more abundant, situations may arise when, with minor fractures, emergency surgery will have to wait.

In the eve of June 24^th, Kuuno (56, full name known to Postimees – edit) was taken to emergency medicine department (EMD) of North-Estonia Medical Centre (PERH) by ambulance, with fracture of humerus.

«I was examined, a plaster board laid under the arm, this in turn hung around the neck with a string. Thereafter, I was issued a paper with the number of a taxi and told to go home, they having no room for me,» said the patient needing emergency surgery. «They said stay at home, the [waiting] lines being long, surgery would come within two weeks.»

According to PERH communications manager Inga Lill, plaster cast is problematic with fractures of this sort. «As the patient was entered into emergency surgery list, he was instructed how to keep his arm in a neutral position, helped by the triangular bandage,» she said.

Four days fast

The next day, in the morning Kuuno again called the ambulance as the arm was hurting. This time, the fractured man was hospitalised and sent, as an orthopaedic patient, temporarily into short stay surgery department.

As conformed by the PERH orthopaedics centre head Ants Kass, the department was, at the moment, out of vacancies. It was possible, however, to send the patient into the short stay surgery department, temporarily, as they were having fewer patients. Namely, on June 29^th collective holidays started at the short stay surgery department, wherefore new patients were not being admitted.

Kuuno stayed at the short stay surgery department until June 28^th, waiting for the surgery. «For four days, I was alone in the six-bed ward. They said that any moment I would be operated on,» said the man. Having urged by the staff not to eat or drink prior to surgery, that is what he did for four days. Finally, on June 28^th, surgery time arrived.

According to Kuuno, surgery and the care after that were excellent, him being able to return to work the next day but one.

«I think it is not normal for people to have to wait for days for emergency surgery. The system is faulty,» said Kuuno.

Mr Lill explained that, in summer time, EMD workloads go up. The orthopaedics department being especially busy as people spend a lot of time outdoors and are active in sports. Therefore, sports traumas abound.

According to Mr Kass, in the wake of Midsummer Day, there was an even greater surge of trauma, with further overload on emergency surgery waiting list. «The situation was complicated by the holiday season with fewer staff at work,» said he.

According to Mr Lill, of the three orthopaedics departments, one was on holiday, less beds therefore being available. Meanwhile, the other two departments enlarged capacity for emergency patients at the expense of planned ones; however, it is harder, with emergency patients, to foresee how long they will need to be hospitalised.

Mr Kass said surgeries are performed according to indications. «First, patients with multiple traumas and compound fractures must be operated on. With the kind of fractures [as Kuuno’s] we will try to operate as soon as possible; even so, surgery is also possible after a couple of weeks as the swelling goes down,» he explained, adding that a patient needs not be hospitalised during the waiting period.

According to Mr Kass, all orthopaedics on duty, performing emergency operation, were aware that Kuuno was in need of surgery.

«For safe surgery, prior to anaesthesia, a patient must avoid eating and drinking for minimum six hours. As the patient was in line for emergency surgery, he was advised not to eat and drink,» said Mr Kass.

Sport hurts

Mr Kass said that surgery waiting list was lengthened due to unexpected rise of sports traumas.

While hospitalised, meals were prepared for Kuuno daily, according to Mr Kass. He is sorry that the patient was confused whether he was allowed to eat or not.

At PERH, sports traumas started to go up from end of May. From June 17^th to 24^th, EMD was addressed by 1,581 patients, 256 of which needed to be hospitalised. According to EMD head Kristiina Põld, people mostly came due to falls, sports injuries and cuts. From June 24^th to July 1^st 1,664 people were registered, 254 needing hospitalization.

Last week, the number was 1,601. As underlined by emergency medicine centre head Vassili Novak, half of these came with sports traumas.