Such is the impact of trauma on communities the world over, the World Health Organisation (WHO) states, trauma is a significant cause of death and disability across the globe.
In lieu of this severe impact on both the medical sector and general community—17 October has been earmarked as World Trauma Day. This day stresses the importance of saving and protecting a life during critical moments while educating people on preparing and applying vital measures to deal with and avoid trauma fatalities.
In light of this global initiative, The Newcastillian – Online News speaks to Dr Bianca Cooper, the Principal Clinical Manager at Mediclinic Newcastle, in order to establish the impact, trauma incidents have on Newcastle’s medical sector, as well as what to do in an emergency.
As the frontline medical practitioners dealing with trauma-related cases, what are the common cases Dr Cooper and her team at ER Consulting Inc. attend to, both in Newcastle and on a national level?
The doctor begins by saying, “In Newcastle, the most common cause of trauma is road accidents. However, we are seeing an increase in violent crime such as armed assaults. Nationally, road accidents still account for the largest percentage of trauma seen. However, certain regions do have elevated levels of violent crime.”
When taking stock of the vast array of negative impacts on peoples lives caused through the various forms of trauma, often we tend to overlook the harsh and costly effects on the medical sector.
Therefore, Dr Cooper stresses that dedicated trauma training is expensive for both nursing and doctor staff. Elaborating, “ER Consulting Inc. ensures that all doctors working in our emergency departments are fully trauma trained in order to deal with any eventuality presenting to the emergency centre. Significantly injured patients require a large team of medical professionals to treat them effectively on arrival and this treatment often takes time to achieve stabilisation and transfer to the appropriate level of care.”
Additionally, she explains that while ER Consulting Inc. ensures there are always back up options to assist an overburdened emergency department, large influxes of trauma patients can occasionally cause delays for stable, non-injured patients in the department.
Medical staff, due to their elevated exposure to people, are continually at a higher level of health risks. Dr Cooper emphasises, “As with any consultation, not only trauma, medical professionals face health risks when dealing with patients. These are mostly infective based. COVID-19 comes to mind now, but other infective agents such as HIV and Hepatitis are a risk as well.”
But the risks do not end with health alone, as Dr Cooper points out. “Over the last 2-3 years, we have seen a concerning increase in abuse and aggression towards medical professionals, in some cases resulting in physical violence or threats to life. This scourge is affecting medical practitioners deeply, and many are at the point of considering leaving the profession in entirety. The cause of this is unknown.”
With the above concerning challenges placed on medical practitioners shoulders, what are the main contributing factors to the trauma burden in South Africa?
According to Dr Cooper, the factors contributing to trauma in South Africa are multifactorial. She explains, “Root causes such as unemployment, poor education and poverty are seen as baseline drivers. Confounding factors such as alcohol use/abuse, lack of parental supervision and unsafe environments add to the initial baseline causes.”
Furthermore, she states most trauma programs run in hospital, focus on addressing the lack of knowledge around trauma prevention.
Highlighting this point, she states, “We recently noticed the significant contribution of alcohol to major trauma cases across the country, as these dropped significantly during early lockdown and picked up immediately after alcohol became available.”
Through her experience in the medical industry, working with trauma regularly, Dr Cooper has noted there are several emergencies which occur around the house.
Explaining, “Children can be involved in drownings, poisonings, burn incidents, falls and domestic violence. Adults are essentially the same, although domestic violence is higher in this population.”
In the event of an emergency at home, the doctor stresses it is vital that one contacts the emergency services immediately. Affirming the importance of having these numbers saved on one’s cellphone or posted on the fridge.
Dr Cooper adds, “It is helpful if someone at home is trained in first aid, and it is highly recommended that at least one person is trained in CPR, especially the caregivers of children or elderly persons. For burns, running cold water over the area and applying a damp clean cloth is most effective – avoid ointments and “old wives” remedies such as toothpaste.”
For limb injuries where there is a suspected fracture, Dr Cooper encourages the use of a splint with a cloth or bandage and whatever firm object you have available. “We have seen all sorts of ingenious solutions in the emergency centre, from wooden planks to folded newspapers.”
If there is active bleeding, she says it is important to compress the injury with gauze and a cloth, while applying direct pressure over the wound. She insists “Do not apply a home-made tourniquet.”
In the event of poisoning, contrary to popular belief, forced vomiting or drinking milk is generally not recommended. Dr Cooper urges Newcastillians to instead, with haste, get the victim straight to the emergency centre and try to bring the ingested substance along. Even if the substance isn’t labelled.
The doctor says, “It is fine in most cases, outside of poisoning or intoxication, to give someone who is fully conscious some pain medication at the time of injury. Generally, paracetamol (Panado, Calpol) is the safest.”
Supporting the old saying, Dr Cooper stresses that prevention truly is better than cure.
Therefore, ensure swimming pools and ponds are fenced off, stair handrails are secure, and that drugs and potential poisons are always locked away or kept out of reach of children—remembering to drink alcohol in moderation and avoid dangerous activities such as swimming or driving after drinking.
Many minor traumatic injuries can be managed at home with pain medication and, “RICE” (rest, compression, ice and elevation). However, if you are unsure or not coping, Dr Cooper encourages people to instead see a doctor or rush to the Mediclinic Newcastle emergency centre. “We are here 24 hours a day to help, and it is always best to rule out underlying injuries sooner rather than later,” she points out.
While encouraging people to get to the emergency department as soon as possible, she says, if there is significant trauma, it is paramount to have someone allocated to the task of contacting the ambulance services,in order to assist medical staff when treating the patient.
Dr Cooper adds, “Try to remain calm and relay the events leading up to the incident clearly. Select one person to accompany the patient and relay the information to the doctor and nurse – it is very difficult to garner information from the entire family at one time. If there are chronic medications, the patient is on – bring these with you to the hospital. Once help arrives, either on the scene in the form of an ambulance crew, or in the emergency department, allow the medical team time and space to work.”
As Dr Cooper shares her life-saving knowledge and advice with Newcastillians, it is imperative we as a community follow her words of wisdom, while remembering to work with the very people who are there to save our lives.
Authors: Quinton Boucher and Calvin Swemmer
Editor: Calvin Swemmer