Health Talk

Do seat belts really save lives? How about helmets? This week, Health Talk features Norman Dinerman, M.D., chief of Emergency Services at the Eastern Maine Medical Center, where the new Emergency Department is ready to be introduced to the community. The public is invited to tour the new emergency facilities at EMMC from noon to 7 p.m. Thursday, March 22. The new area features expanded patient treatment and waiting areas, a new Walk-In Care area and state-of-the-art trauma care. Emergency medicine professionals will be on hand to offer tours and answer questions.

What is trauma, and why is the new trauma room in the new EMMC Emergency Department important to people in our part of Maine?

If you were to ask for a scientific definition of trauma, I guess the one that I have found helpful is a breach of anatomical integrity induced by an external force. What that really means is a disruption of the body by an external force.

Over the last 50 years, Americans have become more mobile and now use automobiles daily, and use machines such as high-speed motor boats and snowmobiles for recreation. As a society, we now subject ourselves to a great many means by which we can sustain trauma. As a result, it makes sense that society, and especially the medical care system, prepare for caring for these types of injured people. We are fortunate in the Bangor area to have far less trauma of the penetrating type that comes from the use of knives and guns.

There are many components of trauma and trauma care, starting from the preventive standpoint with seat belt and helmet use and running all the way through rehabilitation. The component of trauma care which is provided in an emergency department, however, focuses on the immediate resuscitation and stabilization of the person who is hurt.

This works in concert with the use of diagnostic equipment to pinpoint the exact injuries and allow a speedy and appropriate transfer to a surgical suite where definitive care can be provided. In the new Emergency Department at EMMC, we are using some of the latest concepts in trauma care along with some technological advances such as special X-ray equipment which will allow us to thoroughly diagnose certain types of injuries without moving the patient from the very stretcher on which he or she was initially placed. We have also used new technology to minimize the chances of contamination of open wounds. Extremely high-intensity lighting and an unusually spacious trauma room also add to the new trauma treatment area at EMMC.

From the point of view of an emergency room physician, are seat belts and helmets really important?

From an emergency department point of view, seat belts and helmets really do everything they are supposed to do. While there is a great myth in the community about whether they do in fact work, there is absolutely no doubt in the minds of physicians and nurses who see the victims of automobile and motorcycle accidents that seat belts and helmets do work.

Seatbelts and helmets have, to an extent almost unimaginable, prevented a great many of the devastating effects of injury and truly do save lives. We are constantly saddened, if not appalled, by the number of people (particularly children) who arrive in various stages of injury from an accident where seat belts were not used.

It is tragic, and we often see injuries which are virtually totally preventable through the use of seat belts, or in smaller children the use of child-restraint seats. Together, they are one of the most fundamental public health measures a society can provide its citizens.

How will people benefit from the new Walk-In Care area at EMMC?

Walk-In Care will enable us to better manage the bulk of the patients that come in for treatment at the emergency department in a manner which is much more rapid than the traditional means. We’ve been pilot-testing a walk-in care facility for a number of years and have assembled a number of criteria for helping patients through this facility. We’ve geared up our X-ray and laboratory testing to specifically address the needs of this type of patient. We hope to get patients through this area extremely promptly and with less delay, as well as lower cost.

What type of patients would use the Walk-In Care service?

These are patients who might have upper respiratory infections, single-extremity injuries and can still walk in, people with minor allergic reactions, children with fevers and gastrointestinal complaints and problems of this nature. The Walk-In Care area can be directly accessed by its own special entrance in the ED, or if you come to the main ED and you can be better treated at Walk-In Care, our trained staff will transfer the patient automatically.

In times of emergency, what should a person bring to the emergency room?

One of the most important things to bring is the name of your primary physician. If you are taking any medications, it is also very helpful to bring a list of those medications and the dosages with you. Often, it becomes important for the emergency department personnel to know your specific treatment regimen.

It is also important for patients who are minors to be sure that their parent or guardian comes to the emergency department so that consent for treatment can be obtained. Obviously in a situation that threatens life or limb, we would go ahead and treat the child. However, under most circumstances it is extremely important that permission for treatment be given by a parent or a guardian.