Friday, September 29, 2023

Burdette Shines Handling Bus Patients

By Christine Cote

COURT HOUSE – Burdette Tomlin Memorial Hospital’s entire staff mobilized June 6 to handle in just over three hours 72 children and two adults involved in a two-school bus accident.
In the 15 years she has been at Burdette, this “disaster” brought the highest amount of patients through its emergency room from one incident, said the NaDean Wristbridge, nurse manager of the emergency department.
There were no serious injuries. Most were seen as a precaution, but histories had to be taken and each had to be seen by a physician.
The accident occurred just after 9 a.m. when one school bus from the Woodstown-Pilesgrove School District struck another from behind at the intersection of routes 9 and 83.
District Superintendent Robert Bumpus drove to the site after hearing of the accident and then went to the hospital to be with students. He told the Herald last week, “I think they (the hospital staff) really distinguished themselves with the response.”
Bumpus said President Joanne Carrocino had told him that they “practice emergency response consistently and it really showed. I was totally impressed.”
Not only was he impressed with the staff’s organization and technical skills, Bumpus said, he “could see they were genuinely concerned. We did not experience one negative comment or emotion. Somebody’s been doing some great public relations work.”
First told about 10 a.m. that they would be getting some 10 students by ambulance from the incident commander at the scene, said Wristbridge, by 11 a.m. they were told that all 72 middle school children would be brought in. The dozen or so students brought by ambulance were immobilized on backboards.
The department was already full that morning, said Wristbridge, with 12 to 14 patients, some experiencing chest pain and shortness of breath. They were kept on track and Wristbridge said the students were split between the sub acute and fast track areas for treatment.
Other patients who came to the department, while students were being seen, received standard attention from the staff. The normal process was used, said Wristbridge, to handle those who walked in with chest pain or other critical complaints.
The department saw a total of 189 patients that day, although Wristbridge said she expected to “break 200.” The census for June 5 was 130 and the department saw 109 patients the day after the bus incident. Last year she told the Herald that during winter her department handles 60 to 120 patients during a 24-hour period, which increases to 130 to 250 during that same period during summer.
At 10 a.m. there was one emergency room physician available with another due in at 11, said Wristbridge.  She thought that those two could handle these examinations and the other patients.
When she got the second call that all the students were to be seen, she “beeped in” Medical Director Michael Dudnick and another emergency room physician to handle the examinations.
She also called a “code triage” to immobilize the entire hospital to assist her department.
That meant that each floor sent a nurse or nurse aid to help and that hospital administrators shifted to different roles. One was to set up a command center to contact parents and deal with calls.
The Maruchi Room, usually used for meetings and conferences, was turned into a place where students could go after they were cleared by the medical staff to have a snack of juice and cookies while they waited to leave.
Parents picked up those who had been brought by ambulance, said Bumpus. Most went back on the buses, which were drivable after the accident.
All the students were treated by 1:20 p.m. and all left Burdette by 1:30 p.m., said Wristbridge.
“I think they were scared,” said Wristbridge, and they were upset about missing the concert they had been traveling to in Cape May. The chaperones really helped in comforting them, she said. They were all well behaved and cooperative.
Although gearing up for increased summer numbers is routine this time of year, an influx of this many patients at once is usually only seen on television.
Wristbridge said her department does see one or two bus accidents a year but even then it typically involves about 40 people.
Usually at the scene of a major accident, she said, medical people decide to send those injured to different hospitals. In this case, she first thought the children were from this area and she “decided to bring them all here because we could accommodate seeing them all.” She did not know who made the decision to have every child examined.
Since she was in the middle of orientation for added summer staff that will be completed this week, Wristbridge had a “hefty staff” that day, with four additional nurses to the eight usually assigned and eight additional technicians added to the six that would normally be scheduled then. The technicians operate similar to nurse aids and can take vital signs and do similar tasks.
Most of the complaints or symptoms were skeletal injuries and headache and stomachaches, said Wristbridge. There were no broken bones and no wounds treated, but about 20 patients were given X-rays.
The influx of that many patients really “taxes a system,” she said.  “It went very well. Everyone worked together.”
The whole hospital pitched in, she said, and every one asked what they could do to help.
“It tested our system and we found it worked well,” she said, although acknowledging that dealing “with 74 critically ill would have been much more difficult.”
Contact Cote at (609) 886-8600 Ext 31 or: ccote@cmcherald.com

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