Regional trauma plan worked, Waco hospital officials say

WACO – Social worker Melissa James, like 284 of her fellow doctors, nurses and other caregivers, answered the call for reinforcements at Hillcrest Baptist Medical Center on Wednesday night.

Unlike most of them, however, James, a 15-year employee of the hospital, went about her duties even as relatives from West were arriving for treatment.

Her stepbrother and nephew were injured by the blast as they passed by the fertilizer plant in their pickup. Her grandfather was in the nursing home located nearby.

Fortunately, she said, all appear to be OK. But that didn’t make the situation any less stressful when it was unfolding.

“Certainly it was very difficult coming to work knowing that my family may be coming into the hospital,” James said at a news conference Thursday afternoon. But her colleagues made it easier for her. “I had wonderful support helping me out and providing me with what I needed to do the work and help me focus too when my family members came in.”

Hillcrest CEO Glenn Robinson said the hospital human resources department calculated that about 60 employees live in the West area. A few, like James, were on hand to comfort injured loved ones.

Robinson said of the nearly 500 hospital staffers who had worked in the 24 hours since the explosion: “I would say their efforts have truly been heroic.”

James said of her family’s close call: “They were just so grateful to be alive and still be here. We didn’t lose any of our family members and that’s just so good.”

‘Controlled chaos’

Officials with Hillcrest, the McLennan County area’s regional trauma center, said at midafternoon Thursday that 28 patients remained hospitalized, five of whom were in intensive care.

“Small numbers” of victims continued to trickle in during the day for treatment, said Dr. Jim Morrison, chief medical officer. The same held true at Waco’s other hospital, Providence Health Center, where three patients had come in Thursday, a spokeswoman said. Fifteen remained hospitalized there out of the 68 who had been seen.

Overall, about 100 patients had been treated at Hillcrest. Two pediatric patients were transferred to Scott & White McLane’s Children’s Hospital in Temple.

Two patients were in critical condition at Parkland Memorial Hospital in Dallas. Three were treated at John Peter Smith Hospital in Fort Worth, including one who was in critical condition.

Trauma surgeon Danny Owens said doctors had treated mostly skin and soft tissue injuries, lung contusions, bruising, eye injuries from flying debris and burst eardrums. No chemical-related injuries had been noted.

“It’s a concern and we’re watching for that, but we have not seen it,” he said.

He said that he and other trauma surgeons were overwhelmed by the professionalism of other caregivers and staffers during a hectic night that he described as “controlled chaos.”

“We talk about this stuff, prepare for it, have regional meetings. You think you’re prepared for it, but you never really know till this happens. And it was great to see everybody ..... work together to make this run smoothly and take care of our patients the best they can be taken care of.”

Gigantic air wave

Three victims of the blast were being treated by JPS Health Network in Fort Worth. The victims were two females and one male between the ages of 80-90 years. JPS confirmed that the victims were from the West nursing home.

Two were listed in fair condition. The third victim was listed in serious condition.

Dr. Raj Gandhi, medical director of trauma services, said a blast creates a “gigantic air wave” that lifts and pushes people with a risk for several types of injuries.

The first hit can bruise a person inside and outside. While the body is moving, it can hit something, including people or debris, which can cause more injuries.

“There’s other people around,” Gandhi said. “Those other people are flying as well. It’s not a simple thing; it is lots of different things happening.”

The types of injuries generally seen in blasts include traumatic brain injuries, skull fractures, ruptured eyes, internal bruising to the lung or other internal organs. There is also the potential for broken arms and legs when people are flung through the air by a blast.

Older blast victims could be crushed by falling ceilings or walls because they are not mobile.

“They don’t have the capacity to heal as well,” Gandhi said, adding that it might not be easy for them to come back as quickly from small injuries.

Older patients tend to be on many medications including blood thinners, which could pose issues during a disaster. Bleeding needs to be controlled before it becomes a big problem, he said.

Gandhi said the West blast exemplifies why Texas trauma dollars are crucial. He said physicians and hospitals were able to be ready for blast victims through coordination with the North Central Texas Trauma Regional Advisory Council.

“Yesterday was as a disaster in all the ways that they are,” Gandhi said. “I believe it was mitigated because we had a prepared system.”

Staff writer Diane Smith contributed to this report.