Pilot program helping Regina deal with 'vast plethora' of gunshot victims
The director of the Regina Trauma Program says the city's surgeons are seeing, "a vast plethora of gunshot victims and gunshot trauma."
Dr. Jagadish Rao said the Regina General Hospital team has dealt with 17 gun-related wounds so far this year, compared to 23 total in 2017, 32 in 2016 and 16 in 2015.
Rao said the change this year has been notable.
Treating the wound
The first step a trauma specialist will take when treating a shooting victim isn't always rushing them to an operating table, Rao said. They might observe the victim in an intensive care unit first.
"Because we are a lower volume (hospital), our intuitiveness, for trying to determine what kind of injuries they might have, is extremely important," Rao said.
What happens depends upon a myriad of factors, but it's guided by vital signs and the trajectory and location of the bullet. CT scans or quick ultrasound exams can help.
No bullet wound, nor its treatment plan, is the same.
"I have been involved in patients who have had a bullet to the heart, where we've actually had to open up their chest in the emergency room in order to stop the bleeding," Rao said.
In another case, a bullet went through a patient's aorta yet the patient remained stable.
He's also seen a patient with a bullet lodged in their rib.
"So it's ricocheted inside the belly, gone into the chest, and yet we've observed those patients non-operatively."
Treatment also depends on how many times they were shot as well as the weapon of choice. Rao said he has seen an uptick in .22 calibre guns.
Rao said ongoing education, like RCMP ballistics expert presentations and video conferences, is crucial.
Doctors also work to prevent complacency, which Rao said is important given that he expects shooting numbers to keep going up.
"We want people to have their so-called spidey senses up and working, so that they do consider the injuries that can occur with these patients," he said.
Rao said the people hit by bullets aren't the only victims.
"We deal with the physical injuries, but there's also the mental injuries that can occur with people who may be in the crossfire of these gun battles and who have to deal with the post-traumatic stress."
Trauma Pilot Project underway in Regina
Rao is overseeing a pilot project underway at the Regina General Hospital to help handle severe trauma — like bullet wounds — and ease the stress on the emergency room.
"We now have people who are experts in dealing with gunshots and gunshot patients," Rao said.
The 18-month pilot project began in July 2017. The goal is to provide immediate and continuous specialized care to trauma victims.
Before the program went live, emergency room physicians would handle trauma cases.
"It often took them away from looking after the patients who came in with heart attacks, patients who came in with a stroke," Rao said.
In the pilot program, a trained trauma specialist attends a shooting victim in the emergency room within 20 minutes.
They then aim to secure a hospital bed within an hour. Rao said patients could wait up to 15 hours before the pilot.
The trauma specialist oversees the patient's entire treatment, including mental health care and continued rehabilitation beyond the hospital.
"We also look for follow ups, so they're not lost in the system."
Rao said the pilot program wraps in December and then it will be up to the Ministry of Health and himself to examine the outcomes and deem if the project is feasible and beneficial.
