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At the HART

One day in the OR: when every second counts

When emergency medical teams tend to patients with multiple severe injuries, there is no room for trial and error. Instead timing, reliability and precision are key – not just for doctors and nurses but also for the tools and supplies they rely on.

It's part of the daily routine in the accident and emergency department (A&E) of any hospital – yet, as most emergency medical staff will attest to, the treatment of polytrauma patients comes with its own distinct challenges. Polytraumas most often occur as a result of traffic accidents. The term is commonly used to describe a series of multiple injuries to various regions of the body of which at least one – or the combination of several – is considered to be life threatening. According to the German Society for Trauma Surgery (DGU) at least one in ten polytrauma patients does not survive.

Portrait shot of Prof Gebhard
Professor Dr. Florian Gebhard

When doctors and nurses in an operating room are instructed to prepare for a polytrauma, they never quite know what to expect – save for the fact that the injuries will be serious and potentially deadly. No two accidents are identical and until the patient can be diagnosed properly everything else is guesswork. "When it comes to polytraumas, there isn't any one injury pattern that's reproducible – every patient is different", says Professor Dr Florian Gebhard, Vice President of the German Trauma Foundation and Medical Director at Ulm University Hospital.

It's a measure of insecurity that can create an additional burden for emergency medical staff who are already exposed to a basic level of stress from having to maintain a constant state of preparedness. The ever-looming possibility of the death of a polytrauma patient translates into yet another further layer of strain. “Although emergency medical staff are generally highly experienced professionals, most will find it difficult to completely ignore the fact that they are operating on a fellow human being”, adds Professor Gebhard.

“Everyone must simply function”

Tending to a polytrauma patient therefore is a stressful situation – and it's one that Madeline Trick finds herself in on a regular basis. The 24-year-old works as a surgeon's assistant in the A&E department at Rechts der Isar Hospital in Munich. When a polytrauma call comes in Ms. Trick and her colleagues often only have minutes to get ready and gather all of their skills and energy. Preparations begin immediately and the team will use the little time that remains before the patient's arrival to lay out and arrange any instruments and supplies that might possibly be required during the imminent medical procedures.

Emergency medical team operating patient on operation table.

"Once the patient enters the emergency room, everything happens very quickly", Ms. Trick says. "The nature and the extent of the injuries are evaluated according to a standard protocol so that treatment can be prioritised according to their severity." She admits that there can be an initial sense of excitement when a polytrauma patient is announced over the phone. But long-standing routines quickly kick in and well-established procedures take over. "Everyone involved must simply function", she says. "Every second counts – especially when major blood vessels have been injured or when the brain is affected."

Trust is key

Unpredictable life-and-death situations with little or no time to spare are a regular recurrence in operating theatres around the world. It is therefore vital that the doctors and nurses who staff those units know exactly what to do and how to perform their duties. They have to work hand in hand, frequently without verbal communication. Trust is key to this intense way of working – those involved must be able to unconditionally depend not only on everyone else in the room but also on the necessary instruments and supplies. Whether it's gowns, surgical gloves, draping sets for the patient, instrument tables or other surgical equipment – every item must be fit for its intended purpose, easy to apply and consistently fulfil the highest standards of quality.

It's a set of requirements that Denise Leistenschneider knows only too well. As a medical advisor with HARTMANN's risk prevention marketing team the certified OR Nurse spends a lot of time in emergency rooms and operating theatres. "My team and I are in close contact with many specialists in various hospitals", she says. "We regularly talk to them about possible pain points they may have when it comes to the equipment they use on a daily basis."

Portrait shot of Denise Leistenschneider
Denise Leistenschneider

During their routine consultations with real-life medical practitioners Ms. Leistenschneider and her colleagues have developed a profound understanding of the requirements that instruments and supplies have to live up to in A&E departments and operating suites. For instance, the draping materials that are used to cover the areas around an injury before the operation begins must be fast and easy to apply as well as sterile and safe. "The same principle applies to the drapes with which the tables for instruments and other accessories are covered", Ms. Leistenschneider says. It may seem negligible but a special folding design that allows an OR nurse to spread a drape over an equipment table without help and with only a flick of the wrist might save vital seconds.

Innovations must offer a measurable added value

Naturally, innovation plays a major role in Denise Leistenschneider's daily work – but that doesn't mean that technological upgrades to HARTMANN's products are her sole focus. After all, when innovation becomes self-serving there's always a danger of missing the central requirements of a product. The key aspects Ms. Leistenschneider and her colleagues look for in any new development therefore haven't changed much over the years. “A product must reduce the burden on medical professionals while at the same time being easy to use”, she explains. “In addition to improving the care provided to a patient it must also offer economic benefits.”

A hand reaching over an operation instrument to another hand.

A recent development that HARTMANN's risk prevention marketing team has been contributing its expertise to is a new draping set that also serves as an all-in-one surgical starter pack. It fully adheres to hospital standards and allows emergency teams to initiate the medical procedures most commonly associated with the treatment of polytraumatic injuries within seconds. It's exactly the kind of equipment that's appreciated by working professionals like Madeline Trick. Pre-packaged kits with the most important surgical instruments and supplies make the lives of those in the operating room much easier because they are more easily handled. "It enables us to spend more time focusing on the patient", Ms. Trick says. "And that, after all, is what our work should be all about: providing the best possible medical care to the patient."

2018 marks HARTMANN’s 200-year anniversary.

To commemorate this milestone, we have put together this series of articles. In it we show how our employees and partners contribute to advancing healthcare, as well as discussing trends and issues that affect the healthcare systems we serve.