Thursday, February 17, 2011

NOW It Makes Sense


There's been a lot of concern in the sports world about the situation with Brandon Banks. Saturday night he was at The Park night club in DC where he and his friend got involved in a fight and the both of them were stabbed. Initially, the reports said that his friend was worse off (being stabbed several times including in the face). But it was reported in the beginning that Banks was only being treated for "superficial wounds." A lot of the concern was with the Redskins organization, thinking that they were not releasing the whole truth about things. But I'd like to look at a different angle.

Superficial wounds, by medical definition, are scratches, scrapes, bumps, bruises, or any other minor injury on the surface of the skin and does not involve muscles, bones, organs, tendons, etc. If this were the case, then someone should have just fixed up his boo boo with some bandages and sent him along the same night. The next day, he was still in the hospital overnight "just to be safe." (Really?) That was Sunday night.

So then, Monday night, he's still in the hospital. Tuesday, they're putting a tube in his chest to prevent his lung from collapsing. Take note that at this point, organs are involved. So it's no longer "superficial." What happened to the boo boo they said he had Saturday??  This is getting fishy.

As I'm writing this, I'm asking myself… "what's the chain of action when there's a street injury?" The first people to respond in this case would be EMT/Paramedics (how convenient that I'm married to one).  They're basically street doctors. There's a chain of actions that they do first when checking out someone called "Patient Assessment." There's a lot to this, but basically it means that they first examine the patient to find out what's going on. They also provide any initial treatment before and/or during transport to a hospital. So if it were just a scratch or minor cut, a EMT/Paramedic should be able to determine in the field that that's all it is.

The next level is the ER. If you go in to an emergency room and tell the doctor that you were involved in a knife fight, the first thing they will ask is, "were you stabbed?" Now, the storylines have said that Banks did not know he was stabbed. So then the doctor's responsibility at that point would be to examine the patient. Again, if the wounds were superficial, they would have cleaned him up, given him some extra bandages, told him to change them every day, and sent him home. But if you were a doctor, and you were afraid that your patient could have been stabbed (even if they are unaware), don't you think it would be wise to at least give them an x-ray or maybe even a CT scan??

If he had an x-ray, they could have caught (or at least suspected) the lung problem EARLY.  But for sake of argument, let's just say he hadn't.

There's two types of pneumothorax (collapsed lung). Tension Pneumothorax is more severe – where air builds up under pressure and usually collapses one or both lungs causing severe dysfunction of the cardiovascular system and if not treated can lead to death. Simple Pneumothorax is usually only a partial collapse of a lung, but not enough pressure built up in the lung cavity to cause cardiovascular dysfunction. This type can be small and stable and may not require emergency treatment but has the potential to progress into something more serious. If severe enough, simple p. may lead to decreased amounts of oxygen in the blood causing the patient to feel short of breath.

Now they didn't put a tube in his chest until Tuesday, but he had not yet been discharged. So could it have been possible he started out with simple p and then ended up with tension p? You would have to think that it was not until Tuesday (more than 48 hours later) when the doctors began suspecting the collapsed lung (which makes sense to why they didn't insert a tube until then). So what took so long? If he had a x-ray of CT scan to begin with, wouldn't they have caught this sooner? And if they had, who was the judge that it didn't require treatment?

Then yesterday, I saw the report that his lung indeed collapsed. But alas, I was stuck with merely the news reports until I started looking into treatment for this condition so then I could only say, "what kind of hospital did they take him to???"  I also thought, "Didn't they put in the tube to prevent this?? What kind of hospital can't treat a collapsed lung?? Or even prevent one??"

Last night, as I watched the 10:00 news, I saw the report that said he was being transported to Virginia Hospital Center. I blew a sigh of relief. Because just from the chain of actions, it seemed as if where he was could not accurately assess and/or treat him.  Then there was statement released by Banks' agent saying that Brandon would like to "thank the doctors and nurses at Howard University Hospital for their care." (Insert shocked face).

The same place my late grandfather begged to leave when he was being treated there for much more serious problems. The same place with a list of complaints about the level of care. The same place that is regarded as one of the worst (if not the worst) hospital in the DMV. The same place that not only has battled a number of malpractice lawsuits in recent years but also nearly lost its accreditation not that long ago.

NOW it makes sense.