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San Diego Scripps Health Trauma Team Heads To Nepal To Aid Quake Survivors

San Diego Scripps Health Trauma Team Heads To Nepal To Aid Quake Survivors
San Diego Scripps Health Trauma Team Heads To Nepal To Aid Quake Survivors
San Diego Scripps Health Trauma Team Heads To Nepal To Aid Quake Survivors GUESTS:Chris Van Gorder, president and CEO, Scripps Health Dr. Mark Olcott, emergency room physician, Scripps Green Hospital

Normally, if a mobile field hospital -- we found out this morning they will not deploy the mobile field hospital. Now the team, when it gets there, could end up anywhere in the country. If the mobile field hospital had been deployed, most likely it would have been put up right THERE AT THE AIRPORT. IT IS DIFFICULT TO TRANSPORT. SO THEY WOULD HAVE PUT IT AT THE AIRPORT. NOW WE COULD END UP ANYWHERE IN THE FALL. ________________________________________ SCRIPPS HAS SENT A TRAUMA TEAM TO OTHER DISASTER ZONES. YOU HAVE BEEN ON SOME OF THOSE MISSIONS. IS THAT RIGHT? ________________________________________ I HAVE BEEN ON ALL OF THEM. ________________________________________ WHERE? ________________________________________ INITIALLY, AFTER HURRICANE KATRINA. WE ACTUALLY ENDED UP IN THE HOUSTON AREA. AND TOOK CARE OF THE SURVIVORS FROM HURRICANE KATRINA. THEN WE WERE ASKED TO ACTUALLY HELP DEVELOP THE MOBILE FIELD HOSPITAL IN THE STATE OF CALIFORNIA AFTER THE GOVERNOR BOB THEM. WE WROTE TO THE POLICIES AND PROCEDURES AND USED -- THE MEDICAL RESPONSE TEAM WHICH WOULD BE SUPPLEMENTED BY THE DISASTER MEDICAL ASSISTANCE TEAMS AND CALIFORNIA MEDICAL ASSISTANT TEAMS. AND THEN THE ADMINISTRATIVE UNITS. WE SET THAT ALL UP. AS A RESULT OF THAT, AFTER THE HURRICANE IN HAITI, THE STATE OFFERED THE MOBILE FIELD HOSPITALS TO THE FEDERAL GOVERNMENT. IN THE END, THEY DIDN'T USE IT. WE DECIDED TO GO IN ANYWAY. IN HAITI, WE HAD THREE DIFFERENT MISSIONS. ________________________________________ HAITI, AND OTHER EARTH BREAK -- EARTHQUAKE DISASTER. WHAT WERE THE MOST MEDICAL SERVICES YOU NEEDED THEIR? ________________________________________ OUR CHIEF MEDICAL OFFICER AND I MISSED -- WE WENT IN INITIALLY AND IT WAS A DEVASTATING ENVIRONMENT. FRANKLY MUCH, MUCH WORSE THAN I THOUGHT WE WOULD SEE IN THE PAUL. A LOT OF ORTHOPEDIC INJURIES. PEOPLE WITH MAJOR HEAD INJURIES -- MOST OF THOSE PEOPLE HAD EITHER PASSED AWAY OR WERE RECEIVING APPROPRIATE CARE. WE SAW A LOT OF EXTREMITY INJURIES. A LOT OF AMPUTATIONS. WE WERE ABLE TO BRING OUR TEAM IN AND WE HAD ANESTHESIOLOGIST AND TRAUMA SURGEONS. WE WERE ABLE TO HELP. ________________________________________ I UNDERSTAND THIS IS YOUR FIRST TRIP WITH THE SCRIPPS TRAUMA TEAM. WHAT DO YOU THINK HAS PREPARED YOU FOR THIS MISSION? ________________________________________ A VARIETY OF THINGS. I SPENT THE FIRST DECADE OF MY CAREER PRACTICING EMERGENCY MEDICINE AND THE U.S. NAVY. MY RESIDENCY TRAINING AND MY FIELD EXPERIENCE -- THE START OF MY CAREER REALLY AIMS RIGHT TO WORD THIS SORT OF PRACTICE OUT OF THE HOSPITAL AND ON CONDITIONS AT THE OTHER SIDE OF THE WORLD. SINCE JOINING SCRIPPS HEALTH SEVERAL YEARS AGO, I HAVE BEEN INVOLVED WITH THE MEDICAL RESPONSE TEAM AND HAVE TRAINED WITH THE MEDICAL RESPONSE TEAM. I AM COMFORTABLE WITH OUR PREPARATIONS FOR THIS. ________________________________________ WHAT KIND OF PREPARATION HAS TO BE DONE HERE AS OPPOSED TO WHEN YOU DO GET WHEREVER IT IS YOU ARE GOING IN NEPAL? ________________________________________ A LOT OF THE PREPARATION -- REALLY STARTED YEARS AGO. IT INVOLVES ESTABLISHING RELATIONSHIPS WITH THE FOLKS THAT WILL PROVIDE OUR LOGISTICS. IN THIS CASE, WITH THE INTERNATIONAL MEDICAL CORPS. A BALDING -- INVOLVING ESTABLISHING RELATIONSHIPS WITH THE OTHER INSTITUTIONS THAT WILL BE SENDING PERSONAL TO THE AREA. WE ANTICIPATE DEPLOYING ALONG WITH PHYSICIANS AND NURSES FROM STANFORD AND HARVARD. SO THOSE TYPES OF RELATIONSHIPS REALLY NEED TO START AND BE BUILT LONG BEFORE THE DISASTER OCCURS IF YOU ARE GOING TO DEPLOY TOGETHER AND OPERATE TOGETHER. IN TERMS OF MEDICAL TRAINING, SOMETHING THAT WAS A CORE PART OF EMERGENCY MEDICINE AND TRAUMA MEDICINE. BUT WE ALSO -- WE ALL WORK TO STAY UP-TO-DATE ON THE LATEST TECHNIQUES. IT IS REALLY BOTH A CLINICAL COMPONENTS, BUT ALMOST MUCH MORE SO, A COORDINATION COMPONENTS. ________________________________________ WHAT KIND OF PRECAUTIONS DO NUMBERS OF THE TEAM HAVE TO TAKE? I UNDERSTAND THEY HAVE TO GET SOME VACCINATIONS. ________________________________________ CORRECT. WE ACTUALLY USE OUR OCCUPATIONAL MEDICINE PHYSICIAN AT SCRIPPS TO DETERMINE THE AREA, THE ENVIRONMENT WE ARE GOING TO AND WHAT WILL BE REQUIRED. SO ALL OF OUR PEOPLE ARE GETTING TYPHOID VACCINATIONS. IT IS GOOD FOR ABOUT TWO YEARS. SO THE PEOPLE WHO GOT VACCINATED LAST TIME -- WHEN HE WENT INTO HAITI -- WILL LEAD THEM AGAIN. AND ANOTHER ARRAY OF VACCINATIONS THEY WILL NEED. IN ADDITION, WE ALWAYS SEND EACH INDIVIDUAL WITH THEIR OWN MEDICAL KIT. WE HAVE EVERYTHING FROM PEPTO-BISMOL, TO EPIPEN. SO THEY MAY NEED THEM FOR THEIR OWN PERSONAL CARE. SO WE HAVE THEM ALL TAKEN CARE OF AS WELL. THERE IS A LOT OF LONG-TERM PREPARATION AND THERE IS A SHORT-TERM PREPARATION REQUIRED SO THAT WE CAN HAVE OUR PEOPLE PREPARED SAFELY WHEN THEY DEPLOY. ________________________________________ WHEN DID THEY DECIDE, CHRIS, TO SEND YOU TO NEPAL? ________________________________________ WHEN THEY CALL THIS. ________________________________________ WHEN WAS THAT. ________________________________________ ABOUT 24 UP TO 48 HOURS AFTER THE ACTUAL EARTHQUAKE. THE DISASTER PREPAREDNESS WAS IN CONTACT ALREADY WITH THE INTERNATIONAL MEDICAL CORPS. THAT IS WHAT WE DO. ALONG WITH STANFORD AND HARVARD, WE'RE READY TO WORK TOGETHER WHEN THE MOBILE FIELD HOSPITAL IS DEPLOYED. SO WE WENT ON STANDBY. AND PROBABLY, ABOUT 24 HOURS AGO, WE WERE TAKEN OFF STANDBY AND PUT ON FULL ALERT. PEOPLE WERE ALREADY PREPARING. WHEN WE WENT ON FULL ALERT, -- IT WAS DEVELOPING THE FINAL ROSTER AND MAKING SURE WE WERE READY TO GO. WE GOT THE DEPLOYMENT ORDERS YESTERDAY. WE'RE TOLD ANYWHERE BETWEEN THURSDAY, TOMORROW, AND FRIDAY. THAT THINGS ARE VERY FLUID. AS I SAID, NOW THAT THE MOBILE FIELD HOSPITAL IS BEING DEPLOYED -- IT COULD BE THURSDAY, FRIDAY, SATURDAY -- WHO KNOWS? WE ARE ON STANDBY AND READY TO GO AT A MOMENTS NOTICE. ________________________________________ WHAT IS THE MIX OF MEDICAL SPECIALTIES ON THIS TEAM DR. MARK OLCOTT. ________________________________________ WE HAVE FOUR POSITIONS FOR THIS FIRST TEAM. TWO EMERGENCY MANAGEMENT POSITIONS AND A SURGE A -- SURGEON EXPERIENCE AND TRAUMA SURGERY. AND WE HAVE AN INTERNAL MEDICINE PHYSICIAN EXPERIENCED IN INTERNAL MEDICINE AND HOSPITAL MEDICINE. SO WE REALLY GOT A GREAT MIX THAT PRODUCES A VERY CAPABLE TEAM FOR THESE SORTS OF INITIAL INJURIES AND INITIAL STABILIZATION AND CARE. ________________________________________ CHRIS VAN GORDER, DOES SCRIPPS HEALTH GET ANY BENEFIT OUT OF SENDING MEDICAL TEAMS TO DISASTER AREAS? ________________________________________ WE DO. I HOPE THE COMMUNITY DOES AS WELL. WE STARTED DOING THIS BECAUSE IT WAS THE RIGHT THING TO DO. WE HAVE VERY, VERY SKILLED PHYSICIANS AND NURSES AND TECHNICIANS AND SUPPORT PEOPLE WANTING TO HELP. I DON'T KNOW HOW YOU FEEL. BUT EVERY TIME I SEE A DISASTER LIKE this, I say, what can I do to help? We have resources that can do that. Alternately we were able to use them in that way. We also bring back experience. The most likely disaster in this community is fire and earthquake. And we have been now -- to one major earthquake. We're going to another one. And we bring back doctors that have experience being in those conditions. Working when not every tool and specialist and piece of equipment you need might be available. Sometimes operating without any power and lights. And that might happen here in this community. And if that is the first time that ever happens, it will be tough to operate. But if you have experienced -- we have been able to bring doctors back and the teach others how to operate in that kind of environment. So we will -- we will function much better in this community. I think there is great value. ________________________________________ What does the rest of the staff at Scripps think about this? ________________________________________ When I put out the notice we were going, I think I received over 200 e-mails now with everything from, God bless you, to, we are so proud of you, to can we be on the team? I think it boosts morale dramatically at our organization when we do something like this for the community. ________________________________________ Have either of you been informed how exactly the team is going to get into Nepal? ________________________________________ There are two options. One would be -- when military aircraft -- most likely that would have happened at the mobile field hospital being deployed. Otherwise, it could be commercial aviation. That might be part of the problem right now. We have heard -- in Kathmandu, aircraft coming in and out, it has been all backed up. Very difficult. A lot of people trying to leave the country. Waiting for flights. That is a big logistics issue. And that may be part of the problem they made a change in the mission a little bit. ________________________________________ As the days pass, in addition to trauma injuries Dr. Mark Olcott, what other kinds of medical help do you think might be needed? ________________________________________ You are exactly right. It is fairly predictable phases of medical problems that we're going to see. You are right. Initially, it is trauma. And still for the coming days, there will be people that still need care for their initial traumatic needs. The other thing we look at our people who have had chronic medical conditions that be, unstable because of -- either lack of usual medical care or lack of medicine, to the overall stress of the event. So there is definitely a Spike in people with chronic medical issues that require acute care. And then as we transition, over the next week or two, into people living in conditions that might not have the normal sanitation and challenging conditions -- ________________________________________ A lot of people apparently are living outside -- ________________________________________ Exactly - ________________________________________ Exactly what we're hearing. In those conditions, you would expect some contagious disease to spread in terms of contagious diseases. The really the acute trauma -- the medical patient with chronic issues and then the sanitation or lifestyle related issues -- are really the spectrum of medical problems that we prepare for and expect to see over the next two or three weeks. ________________________________________ Chris, I understand when a Scripps team was in Haiti, there were a lot of pregnant women that you had to attend to because they had not seen a doctor before. ________________________________________ Just like Dr. Mark Olcott said. The first two teams dealing with traumatic injuries. Open fractures that literally were 10 days old or gangrenous legs or infections -- it was pretty ugly. By the third -- by the time the third team got there, that had all been taken care of. We had an obstetrician we brought in. There was a long line of women that had never seen a physician before. And she had to learn how to speed up our examinations to be able to treat a large number of people. Again, she learned in a disaster situation that you do things very differently than you might do things at home. But the mission had changed dramatically in a matter of three weeks. ________________________________________ Now, you brought this up before. I would like for you to talk more about this. When most of us here about a disaster, the most we can do -- and I know it is gratefully appreciated -- is to send a donation. But what is it actually like to be able to help the people who are suffering? ________________________________________ You know, I have done a lot of things in my life that I feel very rewarded about -- I was a police officer and have worked in healthcare most of my career. But I will tell you, going to Katrina, after the hurricane or to Haiti after the earthquake there, and being able to take care of people -- you are not thinking about bureaucracy and billing. All it is about is a human being that needs care. And we have an ability to help. And we're hoping. I will never forget going in -- we always wear this -- we always where are the edification. And I had a special badge with the American flag on it. Nobody knows who Scripps is in Haiti. They recognize the American flag. And when they saw that, this miles on them -- people were badly injured and you would see a smile on their face. They knew that help arrived. A week or two later, we saw the fear come back and their eyes because the Americans were leaving again. I came home feeling so satisfied and gratified that I have the ability. So many people want to help. And I have the chance to help. That is an experience that is a once-in-a-lifetime experience. ________________________________________ I know you have volunteered before Dr. Olcott in Baja, California and so forth. I will ask you the same question. We are not just writing out a check or making a donation online, -- but to actually see the people you are helping, what is that like? ________________________________________ It really cuts to the heart of why we all went into healthcare. I know I speak for everybody on the team. And for everybody at Scripps health. The ability to have a direct impact on making somebody's life better -- whether it is through fixing an immediate injury or whether it is through develop -- Delivering hope as Chris mentioned -- that help has come, that is why we went into this arena to begin with. And this is a challenging time in American healthcare, as you well know. And there are a lot of distractions. There are lots of the saddest fires that can sort of creep into your mind -- peripheral to the care that we provide. This is an amazing gift for everybody on the team to be able to go and deliver healthcare in its purest form. As Chris said, without worry of billing and lots of those other distractions. So it is really a privilege to be able to do this. ________________________________________ I have a card that I still have on my desk today. A yellow card. On the front of it, it is a child's drawing -- and it says, have hope. You open it up and it says, help is on the way. We picked that off the floor of the convention center in Houston. And one of the team members gave it to me. That has kind of then are simple for our team ever since. Have hope, help is on the way. ________________________________________ [Indiscernible/Multiple Speakers] -- Chris Van Gorder, president and CEO at Scripps, thank you for speaking with us. Dr. Mark Olcott, thank you. Good luck and stay safe.

The death toll is still rising in Nepal following the 7.8-magnitude quake Saturday with more than 5,200 people confirmed dead.

Another 10,000 people have been injured, according to Nepal's National Emergency Operation Center, and rescue crews are only now reaching some of the outlining areas surrounding Kathmandu.

A trauma team from Scripps Health in San Diego will go to Nepal to help earthquake survivors.

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"About 24 hours ago we were put on full alert," Chris Van Gorder, CEO of Scripps Health, told KPBS Edition on Wednesday. "We're developing the final roster and we're ready to go at a moment's notice. The team, when it gets there, can end up anywhere in the country."

Mark Olcott, an emergency room physician at Scripps Green Hospital, who went on three missions to Haiti said assessment teams are feeding them information on what to expect.

"There is long-term preparation and there is short-term preparation so we can have our people safe," Olcott said. "The timing is very poor as monsoon typically begins in May."

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