Annual Report 2006
Our lifetime of experience has readied us for your experience of a lifetime.

“You have to live life to the fullest. You’ll go when you’re supposed to. It wasn’t my time yet.” Brian Landis Victim of a Traumatic Accident
	Annual Report 2006
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	Hospital Expansion
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Surgery

Three minutes seems insignificant. It’s about the time it takes to grab a snack or fill your gas tank, but for teenager Brian Landis, it meant the difference between life and death.

Brian arrived in Grand View’s Emergency Department in his brother’s car on Friday afternoon, April 21st. The high-school junior had lost consciousness. Minutes earlier, he had been playing basketball with his little sister. Charging for the ball, he raised his hand to avoid colliding with her. He punched through a garage-door window, slicing his arm and a major artery. The cut was so deep it dislodged the muscle. Brian recalls pushing it back into place. With no time to spare, his brother raced him to the hospital. “My brother kept yelling, ‘Talk to me,’ but I passed out.”

Hearing his brother’s cry for help, emergency medical technicians began life-saving measures. Nurses and physicians spilled from the Emergency Department to help stabilize and transport Brian to a procedure room.

Emergency Department physician Dr. Scott Slagel was one of the first on the scene. The six-inch gash on Brian’s arm cut across his bicep muscle. He had very little pulse and had lost most of his circulating blood. “We gave him six pints of O-negative, uncrossmatched blood because we needed to restore the lost blood immediately to save his life,” Dr. Slagel said. “The nurses were great. We managed to get two big IVs in a patient whose vascular system had nearly collapsed.”

An emergency page was sent to all Grand View surgeons. Dr. David Rilling rushed to the Emergency Department. “Brian was white as a ghost when I arrived,” said Dr. Rilling, a Vietnam War-trained trauma surgeon. “He was gasping for breath and almost lifeless. We removed the bandage, and blood squirted everywhere.”

Dr. Edwin Shearburn arrived just minutes later. “When an artery is severed completely, it seals, which is the body’s way of protecting itself,” he explained. “In Brian’s case, only about 90 percent of the artery was cut so it remained open, causing him to bleed profusely.”

Dr. Rilling credits the Emergency Department staff with bringing Brian back from the brink of death. “They did the exact right thing at the exact right time. They were very organized,” he said.

Two-and-a-Half Hours. Once Brian had sufficient blood in his body, surgeons began restoring his arm. Dr. Rilling, who early in his career had the distinction of being one of the first people to reattach a severed arm, recognized Brian’s injuries as one of the worst he has ever seen. He was amazed at how efficiently the operating-room staff mobilized. Within minutes, the staff had assembled, prepared the room and was ready for action.

During surgery, Dr. Rilling removed the injured part of the artery and sutured together two healthy ends. Meanwhile, Dr. Shearburn repaired the muscle damage. Orthopaedic surgeon Dr. Paul Weidner arrived in the OR to consult with the other surgeons.

“As surgeons, we frequently work with each other,” Dr. Rilling said. “We’re lucky to have experienced surgeons trained in multiple areas.”

Surgery revealed the cut had missed both the vein and nerve. If the nerve had been cut or the artery completely severed, Brian may have lost use of his arm and hand.

Five Days. Following surgery, Brian stayed in the Intensive Coronary Care Unit (ICCU) for three days and was transferred to a medical surgical unit for two more. During this time, doctors, nurses, paramedics and other hospital staff visited to see how he was doing. “Everyone was so concerned about Brian,” his mother, Tammy Strain, stated. Both mother and son said they feel truly blessed for Grand View’s skilled, caring staff. “God was with Brian and everyone at Grand View that day,” Tammy said. Brian agreed, adding, “He’s got my back.”

Dr. Shearburn noted it will be about one year until Brian’s arm fully recovers. It will always bear physical evidence of the gash, but for Brian, that’s OK. He says,“You have to live life to the fullest. You’ll go when you’re supposed to. It wasn’t my time yet.”

a lifetime of experience | Spencer White, Medical Technologist |
Grand View Hospital
When Brian arrived in the Emergency Department, he needed blood...a lot of it and fast. In the laboratory, medical technologist Spencer White got the call. He prepared O-negative blood. Within minutes, he tested a sample of Brian’s blood with the donor’s to ensure compatibility and delivered the blood to the ED.

Years of training as a corpsman in the Navy and later in the Navy and Coast Guard Reserves had prepared Spencer for traumatic situations. “I didn’t do anything extraordinary,” he said. “Maybe my experience and everything I’ve done over the years made me more efficient and quicker, but I was just doing my job.”

“Back when I first started in the lab, you were a real scientist,” Spencer said. “You got to shake and cook things and do the chemistry yourself.” Still, Spencer finds his job challenging. While medical technologists conducted about 20 tests 30 years ago, today they perform about 200 and must understand the technology to keep the machines operating properly.

Working in the laboratory, technologists rarely meet patients, but Spencer made it a point to see Brian. “When I introduced myself, Brian said, ‘Ah, you’re one of the ones who saved my life.’ That meant everything to me. At that point, they wouldn’t even have had to pay me. It was so rewarding.”

New Option Reduces Pain, Speeds Recovery for Knee-Replacement Patients
Patients receiving a new pain-management option offered in Grand View’s Joint Replacement Center are experiencing less pain and drug-related side effects in the first few days following knee surgery. “As a result, patients start rehabilitation earlier, get their knee moving quicker and go home sooner,” said Dr. James L. Bumgardner, one of two orthopaedic surgeons offering the technique.

Using a mixture of three drugs to reduce pain and inflammation, Dr. Bumgardner injects the solution into the deep tissue below the knee cap at the time of surgery and inserts a catheter to access the area later. After cementing the prosthesis, he injects additional solution into the tissue above the knee before closing the surgery site. “I was amazed at how little pain people had,” Dr. Bumgardner said. “When I visited patients the morning after surgery, they inevitably say, ‘I have no pain.’ ” Dr. Bumgardner began using the new procedure in March to reduce heavy narcotic use for pain relief after surgery. The narcotics often caused patients to have nausea and vomiting. In addition to making patients uncomfortable, symptoms hampered the start of rehabilitation.

“Patients who receive the medication mixture use about half as much narcotic post-op,” said Janice Hunsberger, RN, Joint Center coordinator. “They’re more comfortable and return to activity faster.” Hunsberger has been following patients who have had the new procedure, and all have responded well. Besides Dr. Bumgardner, orthopaedic surgeon Dr. Paul Weidner is seeing excellent results using a similar technique. Patients of both surgeons were able to begin intense therapy the day after surgery.

Ellida Blauvelt, physical therapist, noted, “It is an amazing contrast from the old technique for pain control. Patients are able to do their exercises on their own and get out of bed and walk with minimal help.”

“I’m using this procedure on all of my patients now, regardless of age or health status,” Dr. Bumgardner said. “We’ve had no complications. It’s remarkable.”