Accidents can happen at any moment in life. For the Gupta family in Howrah, they are yet to come out of the mental trauma when their only son Vansh, eight years old jumped from the fifth floor and was in a semi-conscious state. The child was wheeled into the hospital with multiple trauma and chances of his survival was bleak. The trauma team comprising of Neurosurgeon, cardiovascular surgeon, chest physician, pediatrician, and orthopedics all came forward to treat the child. Though the prognosis was relatively poor, the team did not lose hope and it was the belief that Gupta family had on the team which gave moral support to the doctors. The entire team had a prompt and continuous interaction with the patient family who were given regular updates on patient’s condition.
Vansh’s mother narrated that he was their only son who was a school student and had a simple childhood like any other child of his age. However, one day he returned from school, instead of staying in his room he went straight to the terrace and jumped off. Vansh’s mother further described, “We were clueless. We had no idea what to do. It is impossible for me to narrate my state of mind. We immediately brought him to CMRI and the trauma team under Dr. Tapas Chatterjee, Consultant Neurosurgeon, CK Birla Hospitals- CMRI had instantly attended to him, giving him the best possible emergency care.”
The trauma team included neuro-surgeon Dr. Chatterjee, cardiac surgeon Dr. S. Sarengi, pediatrician Dr. S. Acharya, orthopedics Dr. TN Sarkar, and nurses of the hospital, who ensured rapid action and quality patient care. Vansh was admitted in a comatose condition with severe head injury and chest injury. Additionally, he had difficulty in breathing, multiple limb fractures in his right upper limb and lower limb and, also an injury in the hip region. He was immediately intubated. The gravity of the situation colossally aggravated due to the multiplicity of the injury and initial management of it was much needed to stabilize his condition. A CT Scan of the brain confirmed a severe condition known as Diffuse axonal injury, while another CT scan of the thorax showed severe chest injury. Research shows that poly-trauma is one of the leading cause of death and disability in children and young adults across the world. Most of the deaths occur in the first hour following the accident, fall from the height, burn, bullet injuries etc. Hence, management during the first hour which is called the ‘golden hour of trauma’ is vital.
The trauma and surgical care team at CK Birla Hospitals – CMRI primarily worked on stabilizing the patient’s condition. The doctors took care of his head injury on priority and then they had put a drain in the thorax. The child had serious wounds which were alleviated with necessary medication. His chest infection was treated at the same time. Spasticity of the limb was a result of the head injury which was treated accordingly. The patient slowly became steady. The surgical team then decided to operate his multiple injuries in his limb and hip area. After his surgery, he stayed at the hospital for more than a month, recovered well under the specialized care of the doctors and paramedics. He became properly conscious, oriented, spoke to the doctors and his family normally. Though he still had some difficulty in raising his right upper limb, he had gone through regular physiotherapy for complete cure.
“While treating a trauma patient we prioritize the patient’s needs and promptly attend it to stabilize his/her condition. With state-of-the-art advanced tertiary medical care services provided at CMRI, we are among very few hospitals in Kolkata who are well-equipped to handle poly-trauma incidences. As such cases are extremely sensitive and there is a need for instant decision making by the doctors as well as the family, we make it a point to extensively counsel the family before choosing the required line of treatment. In this case I would say it was the fighting ability of the child and the patience of the family as well as their trust towards our treatment plan which have given a good clinical outcome.” said Dr. Tapas Chatterjee, Consultant, Department of Neurosurgery, CK Birla Hospitals- CMRI.
Vansh was sent home after two months. He can now talk, does not require tube feeding, can recognize people. Doctors are of opinion that he will soon get more better. Vansh’s mother concludes, “The doctors’ commitment and dedication have given me the support to go on. I can never thank enough the doctors for their help which have given a new life to my son. “
In poly-trauma cases, the essential goal is to save lives and limit long-term effects. Hence, all modality of treatment mandatory for trauma management must be available 24×7. It is important for the mass to drive awareness about such emergency occurrences. Dr. Chatterjee suggests top five significant factors to be kept in mind while attending a poly-trauma patient:
1. First and the most substantial step is to admit the patient to a hospital. If tertiary care hospitals are not nearby then take the patient to a primary care center and shift him/her once he/she is stable.
2. Head injury takes priority over all other injuries though any injury of any other system should also be addressed simultaneously.
3. Keep your line of communication with the doctors and hospital management transparent. Attend the counseling session and discuss about both the improvement and risk factors involved. Learn what can work and what can go wrong for the patient. This will help you to take an informed decision.
4. Trauma management needs constant cooperation amongst family members, doctors, and hospital management. Hence, have faith in your doctor and listen to doctor’s advice.
5. Lastly, encourage your patient during the recovery process so that he/she attends the therapy session, goes for regular check-ups, and never skips any medication.
Author- Suggested by Dr. Tapas Chatterjee, Consultant Neurosurgeon, CK Birla Hospitals- CMRI
Photograph by-নিজস্ব প্রতিনিধি