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Hospital trip takes 11/2 hours

August 06, 2002|by LAURA ERNDE

laurae@herald-mail.com

A Glen Burnie, Md., man who suffered a head injury Friday waited 90 minutes to get to a hospital, in part because the Washington County Hospital Trauma Center was closed, emergency workers said.

Justin Nathaniel Fishell, 25, remained in critical condition Monday at the University of Maryland Shock Trauma Center in Baltimore.

Fishell was performing stunts for videotape at the Mason-Dixon Dragway on U.S. 40 east of Hagerstown when he lost control of his four-wheel drive all-terrain vehicle and fell onto the pavement, Maryland State Police said.

He was not wearing a helmet, police said.

Dispatchers said the accident was reported at 5:23 p.m. A Maryland State Police helicopter delivered Fishell to the Shock Trauma Center in Baltimore at 6:55 p.m., said Cpl. Donald Lehman of the state police Aviation Division, who was not on the call but had the log from the flight.

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Emergency crews try to get trauma victims to the hospital as quickly as possible because patients fare better when they get treatment within the so-called golden hour, he said.

"His golden hour was shot ... because there's no trauma center in Washington County," Lehman said.

Dr. R Adams Cowley, who spearheaded Maryland's shock-trauma system, discovered the importance of stabilizing trauma victims within what he termed "the golden hour," the first hour after they are injured.

Lehman and others could not say whether Fishell would be in better shape had he gotten to a hospital sooner.

Washington County Hospital's Trauma Center closed June 1. Hospital officials said the closure came because they could no longer promise 24-hour coverage for trauma surgery. A task force is trying to find ways to solve the problem.

Had the trauma center been open, Fishell would have been taken there by ambulance, Lehman said. The distance from the dragway to the hospital is about eight miles.

Instead, emergency crews on the scene called a state police helicopter to fly the patient to Shock Trauma in Baltimore.

The helicopter was tied up on a previous emergency and had to refuel before going out again. It didn't pick up Fishell until 37 minutes after the accident, Lehman said.

Meanwhile, Boonsboro Ambulance Medic Clifford Davis treated Fishell by immobilizing him on a backboard and administering intravenous fluids.

Treatment was difficult because the injury caused Fishell to become combative, he said.

In addition, Fishell was vomiting and medics were fighting to keep his airway clear so he could breathe, he said.

Davis said Washington County Hospital refused to take his patient, even temporarily, because the emergency room was too busy.

Hospital spokeswoman Kelly Redmond said the hospital was on "yellow alert," which means the emergency room is full. In that case, ambulances are asked to take patients elsewhere unless it would lengthen the time before they reach a hospital by more than 20 minutes, Redmond said.

However, it is hospital policy to accept and stabilize all critically injured patients such as Fishell, even under yellow alert, Redmond said.

Hospital officials were trying to determine the reason for the discrepancy, she said.

Washington County Emergency Services Director Joseph Kroboth said he also was looking into the incident.

It was 6 p.m. when the helicopter met up with the Boonsboro ambulance at Myersville, Md., Lehman said.

The helicopter remained on the ground for another 30 minutes until Fishell's airway was no longer blocked by vomiting, Lehman said.

Just before the accident, Fishell was doing a wheelie and looked over his right shoulder at the video camera. When he looked forward, he lost control and was thrown from the ATV onto the blacktop, police said.

Fishell was new to a group of eight or nine friends who have occasionally rented the dragway to perform stunts on ATVs and motorcycles while being videotaped, said Erik Stottlemyer of Middletown, Md., one of those who rent the dragway.

"We try to keep it in a very safe and very controlled environment," he said.

Most of the riders wear helmets and safety gear. They are not encouraged to do anything dangerous or risky, he said.

Stottlemyer said he had an emergency medical technician from Mount Aetna Volunteer Fire Department on standby at the dragway as a safety precaution. But the injury was too severe for that person to do anything but call for more help, he said.

Fishell was riding slowly when he fell and witnesses were surprised by the extent of the injury, Stottlemyer said.

"It was so senseless. All he had to do was have a helmet on," he said.

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