Newsletter - Bartlett Regional Hospital

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Within a few hours, Jason and his mother, Gemma, were aboard a Learjet on their way to Anchorage. His father and brother followed later that day on a commercial flight. Organized medivac service in Southeast Alaska, now so common as to be taken for granted, was nonexistent 30 years ago. In 1978, Michael Copass, MD, a specialist in neurology and critical care medicine who had long been associated with Harborview Medical Center of the University of Washington in Seattle, was visiting Sitka to teach a course in trauma medicine for medical practitioners. “There was a terrible house fire in Sitka while I was there, and three children were severely burned,” recalled Copass in a recent telephone interview, remembering the tragic events of December 2, 1978. “We had no way to get them to a burn center. I spent all afternoon and evening trying to find a plane—any plane—to transport the, by then, two survivors. We found someone from Oregon who was able to fly up, but it was blowing so bad in Sitka he missed the first approach. By the time the plane arrived, we had one survivor. The child later died somewhere over Chatham Strait.” Upon learning that the last survivor had died, Dr. Copass vowed to do what he could to keep a similar tragedy from ever occurring again. He discussed the situation with two Southeast Alaska colleagues, surgeons Dr. George Longenbaugh of Sitka and Dr. Henry Akiyama of Juneau, both now deceased. “They had each sent a lot of people to Seattle,” Copass explained. He said the travel arrangements in those days further compromised many patients’ already frail medical conditions. “Alaska Airlines was very helpful, but it required taking out nine seats— an arduous process.” Copass succeeded in raising awareness and interest at Harborview, and, by Shelly Deering, RN, shows a fully recovered Jason the interior of the jet that took him to Anchorage last April. 1982, Airlift Northwest, a subsidiary of Harborview Medical Center, was operating in Southeast Alaska. About the same time, trauma life-support training began in Southeast, educating physicians and nurses about the latest techniques in stabilizing patients for transport. Today, two medivac services operate out of Southeast Alaska: Airlift Northwest and Guardian Flight. Every community in the region with an airport that can accommodate a jet airplane is served by these two companies. More remote locations in Southeast are served by the U.S. Coast Guard helicopter base at Sitka. Eric Magnuson, a pilot who has worked for Airlift Northwest, is now flying for Guardian Flight. He is a big admirer of the medivac teams. “I just drive the plane. They are taking care of the patients’ medical and emotional needs, and they do it very, very well. I could not be more impressed, and it is one of the reasons that I like my job.” Rick Janik, RN, is a flight nurse with over a million miles flown on medivacs. “The basic requirement to be an Airlift Northwest flight nurse is five years of critical care experience,” says Janik, who has been with Airlift Northwest in Juneau for 12 years. “Right now, the most junior flight team from the Juneau base, two nurses, has, collectively, 20 years of experience; the experience of some of our two-person teams exceeds 50 years.” Shelly Deering, RN, established the base for Airlift Northwest in Juneau. “One of the biggest things for us— those of us who have been based here for a long time—is the great relationship we have with providers and the teamwork we’ve developed with Capital City Fire & Rescue, with the clinics, and the hospital. It is an amazing collaboration.” According to Deering, the Juneau crew makes over 240 patient transports annually. Company-wide, annual airlifts can exceed 3,500 transports. Airlift Northwest stations one Learjet at its base in Juneau throughout the year, and, during the summer, a day jet from Seattle rotates through the larger Southeast Alaska communities. “The people we transport need to receive the type of care a community hospital can’t provide,” says Janik. “To have specialists, you need to have a certain volume of patients to keep the specialists current. This is not something that can be done in Southeast Alaska—we see the same thing in Washington State. The smaller hospitals have to transfer patients that need tertiary or quaternary care to larger medical centers.” From the vantage point of one who pioneered medivac transfers in Southeast Alaska, Dr. Copass has watched Bartlett achieve the status of a truly regional hospital with “very good doctors and very good nurses. I’ve come up in the middle of the night on a Cheyenne III, gone right into the operating room, HouseCalls — 14
and assisted Bill Palmer in finishing a surgical procedure necessary to stabilize a patient. You don’t get any better than Palmer; same goes for [Dr. Allan] Schlicht,” he says of two long-time Juneau surgeons. “Bob Urata—an excellent physician and a superb leader—I’d have no problem with him taking care of my family. Sure, for normal medical care, Juneau residents can come down to Seattle, but you certainly don’t have to.” There are circumstances in which a patient needs to be transferred to a large medical center, Dr. Copass explains, such as someone suffering multiple traumatic injuries that would require the efforts of several surgeons working simultaneously or a patient who is in need of more intensive or specialty care than a community hospital and its staff can provide. “Some patients need to be transferred. It can be a very hard thing for a doctor to say ‘I can’t do it.’ You spend your entire career saying ‘I can do it.’ ” In Dr. Copass’s estimation, it is the physician who recognizes the limitations of the resources immediately available and makes the call for a medivac who lives up to the highest standards of the profession. As for Jason, his immediate and extended family are forever thankful that Dr. Richard Welling made that call. Several days after Jason and his mother took off from Juneau in an Airlift Northwest Learjet, his life very much in the balance, Jason returned home to be greeted at the arrival gate by a crowd of uncles, aunts, and cousins. If anyone were in doubt as to his recovery, Jason put that to rest by leaving his parents and brother in his wake as he bounded through the airport exit, arms reaching out just before he leapt into the embrace of a loving family. Antibiotic Resistant Microbes Preventing infections Jan Beauchamp, Bartlett’s Infection Prevention Coordinator, has declared the “Hand Hygiene Fair” a great success. “People were really having a blast. We had every participating health care worker make a pledge to ‘practice what I learned in kindergarten’ each and every day.” Following the pledge, which included the promise to wash hands before and after every patient contact, each person traced a hand outline and then signed it. Held in August, the Hand Fair was repeated throughout the week to coincide with each shift. While a fun event, it underlined a serious concern: healthcare acquired infection. The good news is that Bartlett has one of the lowest rates of infection of any similar hospital in the country. The bad news is that infection by Staphylococcus is, well, bad news. Staph is a common bacteria—one in four people will test positive with a skin swab. In most cases, such surface “colonizations” remain benign, but “if staph gets inside you, it can be a big problem,” says Beauchamp. An even bigger problem is the antibiotic resistant strain: methicillin-resistant Staphylococcus aureus, otherwise known as MRSA (MER-suh). About two out of 100 people carry MRSA. According to Beauchamp, MRSA first came to the attention of Bartlett’s health care providers in the 1990s. “People would come in to the emergency room complaining of infected spider bites. Jan Beauchamp administers a hand washing pledge to Bartlett employees. It turned out this was happening all over the county. Then someone wrote a paper and said, Hey, this isn’t spider bites, this is MRSA.” The infections looked similar: red angry boils with a hole in the center. “Pretty soon, we realized very few of the infections we were seeing were spider bites.” While MRSA can present challenges, Beauchamp says it is very uncommon that the condition can’t be resolved—although it is an unpleasant experience. “People get pretty sick. It goes from a pimple yesterday to a four-inch wide boil today. Get that and you’ll feel really ill.” The standard protocol for patients who show MRSA-like symptoms is to use isolation precautions. There are isolation rooms in both the Emergency Department and the Critical Care Unit. “If a patient is in the operating room, it doesn’t matter what the staph strain might be—it’s contagious. What they do is to schedule the operation for the last case of the day, using similar isolation procedures. Then they do an end of the day cleaning, taking extra precautions. We do everything we can to keep everything in room: gowns, gloves; it all stays in the operating room until collected and disposed.” 15 — Fall 2011
Page 1 and 2: HouseCalls Fall We bring healthcare
Page 3 and 4: Caring for the Mentally Ill A highl
Page 5 and 6: me and describe the situation,” h
Page 7 and 8: earning a Bachelor of Science Nursi
Page 9 and 10: Heart Attack Care We achieved a 100
Page 11 and 12: New Diagnostic Imaging Director: Ro
Page 13: wait for home health services to be
Page 17 and 18: approved an operating budget— tha
Page 19 and 20: Profile: Dr. Saltzman, from page 10

Newsletter - Bartlett Regional Hospital

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