For most of us, summer is a time of vacations, leisure and outdoor fun. But for doctors, surgeons, nurses and others who work in the emergency department (ED), summer has long been known as trauma season.
“Trauma season happens when people are out living life and having fun, sometimes too much fun. A lot of times, alcohol is involved in trauma season,” says Marie Vrablik, MD, an emergency medicine physician who practices at Harborview Medical Center and UW Medical Center – Montlake.
Car crashes, boating accidents, injuries while out hiking or climbing, fireworks injuries, stabbings, shootings and fist fights are all more common in the summer.
During summer the ED teams also treat more agricultural and construction workers, people who get injured doing home improvement projects and children falling from open windows.
“In a non-COVID year, summer volumes in the ED are likely equivalent to the peak of flu season and winter viruses, but perhaps slightly busier,” Vrablik says.
How emergency medicine overlaps with neurology
Trauma care in the emergency department impacts specialty care elsewhere in the hospital during the summer and in other seasons. Perhaps no specialty is more connected to work in the ED than neurology.
Vasisht Srinivasan, MD, is a neurointensivist who splits his time between the ED and the neurocritical ICU at Harborview. He has training in neurocritical care, neurosurgery and emergency medicine and sees the overlap between his specialties as a profound one.
Given his dual expertise, he also helps patient care go smoothly between both units.
“If I’m in the ICU and we get a call, I usually just go talk to the ED attendings and learn more about the patient. If I’m working in the ED and I know a patient is going to the neuro ICU, I just give the unit a call and let them know while we’re finishing the work up in the ED,” he says.
Srinivasan and other neurointensivists treat patients who have stroke, seizures and, more commonly during summer, traumatic brain injury and spinal cord injury.
Why teamwork is critical in emergency medicine
Around the Fourth of July and other busy seasons, the ED upstaffs, which means they bring on extra people to help. During these and all other times, communication, flexibility and teamwork are key to keep the work going smoothly.
Vrablik has a term for this careful orchestration: a “trauma ballet.”
“Everyone has their mark and job. We try to minimize our chaos as much as possible so we can attend to the chaos of the traumatic injury of the patient,” she explains.
That doesn’t mean that the team doesn’t experience internal chaos, sometimes: It’s difficult to see some of the worst days of peoples’ lives and not always know if a patient is going to recover.
“Our success has a lot to do with preparing in advance. Our physicians train for years, we run simulations with mannequins, we prepare people for the emotions they’re going to feel so it feels less new and scary,” Vrablik says.
The team also regularly debriefs after working with patients to discuss what went well, what didn’t, how everyone is feeling and what learnings to take into the next patient experience.
Despite being in training and medical practice for 12-plus years, Srinivasan still gets a special feeling when he sees everyone working together to help a sick patient.
“ED docs are a very special bunch, though I’m obviously biased. It takes the right kind of person to go in every day and see what we see. We’re the front line of some of the best and worst things humanity has to offer,” he says.
How to stay out of the ED this summer
The harsh truth is that not all traumatic injuries are preventable. Some, however, are.
There are a few themes when it comes to preventing ED visits. A big one is not doing things that would be dangerous if you’re tipsy or drunk, both Vrablik and Srinivasan say. This includes not drinking and driving, operating a boat, swimming or starting a fire. (Don’t use any mind-altering substances while doing those things.)
Another important thing is to be prepared if you’re going hiking, backpacking, camping, rock climbing or doing some other type of outdoor recreation. Have a plan for what you’ll do if you get injured or need help. Bring water and sun protection.
If you have children, don’t let them near open windows. Children falling out of windows is more common than you would think. Even if you have a window screen, this rule still applies as screens can’t support kids’ weight. There are locks and other devices you can get to keep windows partially open but locked so they can’t open far enough for kids to fit through them.
Common sense safety tips, such as wearing a seatbelt in a car and wearing a helmet while biking are critical, too. If you have a gun, keep it in a lock box or other safe storage area and make sure kids can’t access it.
“With the pandemic, it’s been a rough year, so I encourage people to take advantage of the fact the state’s opening up but not lose sight of the fact that these safety precautions have always been true,” says Srinivasan.