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Doctors Address Priestley's Condition

Aired August 12, 2002 - 10:04   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.


LEON HARRIS, CNN ANCHOR: Now we want to hop right over to Kentucky. Lexington, Kentucky, to be specific. There is a press conference underway, doctors are now giving us information about the condition of Jason Priestley, the actor who was in a car accident yesterday.
(JOINED IN PROGRESS)

DR. STEPHAN STAPCZYNSKI, MEDICAL DIRECTOR, KENTUCKY SPEEDWAY: ... last night and this morning, and he continues to be in stable but improving -- serious, stable, and improving condition.

His family and friends have stayed with him through the night. His father, sister, girlfriend, friends, Kelley Racing representatives, Indy Racing League representatives, and other associates are here with him. They wish to thank everyone for their thoughts and prayers during this time of recovery.

Jason is in the intensive care unit at the University of Kentucky Hospital. He was transported there yesterday by our UK Air Medical Service. He was initially evaluated in the emergency department, and underwent diagnostic tests, including such things as X-rays, CT scan, angiography, and endoscopy. Jason has a moderate concussion and a fracture to his ninth thoracic vertebra.

He also has some facial injuries with contusions around his left eye and lacerations on his bridge of his nose and cheek and neck, and also has fractures in both feet. He was initially placed on a ventilator until his condition had stabilized, and his evaluation was complete. The ventilator was removed as soon as he could resume breathing completely on his own yesterday afternoon. He will probably take a few days to recover from his concussion before he undergoes operations to repair his orthopedic injuries. Today, we plan to fit him with a back brace and assess the stability of his thoracic vertebra fracture, and his neurologic condition will be closely monitored.

As I said before, his condition remains serious, but stable and improving. His pulse and blood pressure are normal. He continues to breathe on his own. He responds to commands and voluntarily moves all his extremities. We will continue to provide updated medical information through the University of Kentucky's web site at www.uky.edu.

I will be happy to answer questions. Joining me is Dr. Andrew Bernard, trauma surgeon and a member of the Department of Surgery who was with him yesterday and through the night. Also with us today are his father, Lauren (ph) Priestley, Jim Freudenberg, general manager of Kelley Racing, and Ron Green, a representative of the Indy Racing League.

DR. ANDREW BERNARD, TRAUMA SURGEON: Good morning. I was with Mr. Priestley when he arrived yesterday morning, participated in his initial evaluation and stabilization, and as Dr. Stapczynski said, he continues to improve. I believe it's testimony to his overall physical health and design and construction of the vehicle and the excellent care that he received initially in the field. Those things have significantly contributed to his initial early improvement and ongoing improvement.

STAPCZYNSKI: Are there...

QUESTION: (OFF-MIKE) ... the brain sloshes around when there has been an intense movement of the head and gets bruised. To me, that's a concussion. Am I right with that?

STAPCZYNSKI: It is a blow to the brain that causes neurologic dysfunction. So generally, with the loss of consciousness, a period of amnesia, and then a period of recovery. The actual -- his CT scan did not show any bruising or bleeding, if that's kind of the question you are asking. But he did have a loss of consciousness and a period of amnesia and is now making a recovery.

QUESTION: (OFF-MIKE) How concerned are you about that? To me, neurologically, that could be something that would be of some considerable concern.

BERNARD: That's right. Our most significant concern in fractures of the vertebrae, fractures of the spine, are with neurologic impairment. He has no neurologic impairment at present, and we believe that that fracture will be stable. We will not know for certain if that fracture is stable until he is braced, as the Dr. Stapczynski says, and we have an opportunity to evaluate the stability of fracture, again, in the brace.

QUESTION: (OFF-MIKE) ... surgical procedure for repair, are you talking about like a laminectomy or what?

BERNARD: He will not require any surgical intervention for his spinal fracture.

QUESTION: The surgeries would be for what, then, sir?

BERNARD: Right. The surgery that he will require will be for his foot fractures. Right. He will not require surgery for his spine, if his spine is stable in the brace.

QUESTION: (OFF-MIKE)

STAPCZYNSKI: He was unconscious in the -- at the scene, and through the initial assessment of the emergency department. By unconscious, I mean he could not verbalize or respond to commands, although he was always breathing on his own, and always had stable pulse and blood pressure. Once we intubated him, then we did sedation and other drugs to sort of blunt or to put him to sleep, if you will, so it would be safe to transport him and complete his assessment here. So he was unresponsive until the medications were then removed yesterday afternoon.

QUESTION: Are you talking about the initial diagnosis and the work at the speedway. That was the first real crash you dealt with -- a serious one, that caused concern that -- were you impressed with the response time? I know you guys practice that a lot, but were you able to assess how it went, and would you do anything differently?

STAPCZYNSKI: Yes, We were quite pleased. We have had three years. The track has been in operation for three years. I have been medical director up there, and we have practiced every session and between sessions response. This is the most serious crash that we have had, accident we have had, and we were greatly impressed with the speed of response, the appropriateness of the assessment, the field intervention, the rapid extrication.

We were able to stabilize him promptly and fly him out from accident to arrival here at University of Kentucky, was somewhat in the order of 35 minutes. It is something that we will continue to review, all these events. We have had other accidents there, too, that we continue to review. We will use this as opportunity to improve our response and -- to these such things.

QUESTION: Was there any concern for paralysis in any way, or will he be able to walk again? Or is it still too early to tell?

BERNARD: He doesn't have any evidence of neurologic impairment.

You are speaking in relation it his spine fracture?

He has no evidence of paralysis, neurologic impairment at present, and we don't expect that to develop. But that's part of his ongoing monitoring in the intensive care unit.

QUESTION: Has he been responding, by that -- is he able to speak yet, or is he responding by blinking, or that kind of thing.

BERNARD: He is speaking, and he is interacting with his family and friends and members of his team.

QUESTION: What are your concerns? I'm kind of honing in on this vertebra fracture. What are your concerns? Are you concerned about edema that might develop, or what, since he currently, as far as your evaluation is concerned, has no neurological deficit. What concern do you have about that fracture, if any?

BERNARD: The only concern that I have is that in its stability, and I believe that it's stable. I believe that it will remain stable, in that the structure of the vertebrae will not become more unstable when he is in the up right position. When a trauma patient is evaluated, they are flat on a stretcher, under evaluation. And we know from his X-rays, what that fracture looks like in that position. But when one weights those fractures, when they assume an upright position, sometimes that structure can change. I don't expect that to happen with him, but we will watching for that closely.

QUESTION: Is it fair to say this is currently the most worrisome among this laundry list of injuries. Is that the most worrisome thing from a physician's standpoint?

BERNARD: There are a number of injuries, as you said, and we are considering all those as significant, and I don't think the spine fracture is any -- is significantly more worrisome to me than any of his other injuries. I consider them all to be priorities. And his concussion is equally concerning to me.

QUESTION: The amnesia, for how long of a window does he not remember, and does he now remember everything?

BERNARD: It's too early for us to determine that. He has not yet recovered if his concussion enough for us to fully evaluate that, and that will evolve over time.

QUESTION: Does he know he was in an accident? Does he know how he got here? Any guesses as to where it may start?

BERNARD: Again, it's too early to determine that.

QUESTION: ... as far as the surgeries in the future will take place here at UK. Is there talk of moving him to another facility? What's the early word on that.

BERNARD: No arrangements have been made for transfer.

He has a number of injuries, as we said, and each of those requires its own period of time for recovery. I would suspect it would certainly be weeks before he would back doing most of the things that he would like to do, weeks at least.

But recovery from many of these things is individual to specific type of injury and a specific individual. Like I said before, he's physically healthy. I think that contributed to his tolerance of the crash, and we will have to see how each of those injuries evolves over time.

He will get fitted with his brace. And assuming that his spine is stable in the brace, then we will proceed with progress out of the intensive care unit, as his neurologic function and his brain injury allows. He has fractures in his feet, as you know. Those will limit his physical mobility, in terms of getting out of bed and walking around.

So he won't be able to do those things yet, limited largely because of the fractures in his feet, and the disposition on those operative repairs will determine how soon he is able to get up and rehab from those.

QUESTION: ... if there are no signs of neurological deficits, no signs of bleeding, no signs of paralysis, do you simply take pictures, or do you go by the patient's behavior? Or what do you do?

STAPCZYNSKI: It's the level of consciousness and responsiveness, ability to remember, interact with family and friends, hold a coherent, cogent conversation. It's a functional recovery, as opposed to say an anatomical recovery, and we do that everyday in our normal life by talking to each other, and so that's how we continue to monitor him, by talking to him, listening to what he says, seeing what he can remember and how he can respond.

Obviously, we're avoiding stressing him. We don't want to make him to have to have to work too hard right now to do things. So we do this sort of periodically to get little snapshots. And otherwise try to let him rest and recover.

QUESTION: One, is he still being sedated?

BERNARD: No. No he is receiving pain medication, but no sedation.

QUESTION: The second thing is, how concerned are you as physicians about the concussion? I asked you about the spinal fracture. Now let's talk about the concussion. How concerned are you as a physician?

STAPCZYNSKI: Moderate concussions, as what we see with Jason, have a -- historically have a very good recovery. Everybody is a little bit of an individual, but in general, they have a very good recovery overall.

I think -- his family and friends could relate that a bit better, but they're commenting that it's the young man that they know and love, and he's helping them.

QUESTION: I know it is still early, but do you expect a full recovery, at this point?

BERNARD: He doesn't have any injury that shouldn't fully recover.

QUESTION: Are there any opportunities to speak with Mr. Priestley's father at this occasion?

STAPCZYNSKI: Not at this occasion, no.

On medical issues, if you would like to...

OK, they will answer questions, I guess, individually after the conference.

QUESTION: One other thing, I'm sorry to delay this, but you say he has improved. By improving, you mean now he is off the respirator? He has always been breathing on his own, but he doesn't need the support of the respirator. What else, do you think -- it sounds as though, from a lay point of view, he is kind of getting out of the woods, in a way, the medical woods, would you say that? What does improving mean? STAPCZYNSKI: He is becoming more aware of his surroundings. He can verbalize his name. He can recognize his family and friends. So his neurologic function is the key improvement here, and that's all very -- all been very impressive through the night. Any other questions? I appreciate that -- for your attendance.

And thank you.

LEON HARRIS, CNN ANCHOR: You've been listening to the doctors at the University of Kentucky Chandler Medical Center, who've been treating actor Jason Priestly since his crash yesterday at the Kentucky Speedway, and we just heard the doctors there say they've been handling most of the emergencies at that course for sometime. They're saying that what Jason Priestley was involved in yesterday was the worst accident they have ever had there.

But thanks to the response of the emergency technicians there, they got him to the hospital in a matter of minutes, and that was good news for him.

He is now in a serious, stable, but improving condition. He always has been breathing on his own.

In the hours since the accident yesterday afternoon, he has been undergoing complete battery of diagnostic tests. No operations to this point, and there is a reason for that. While the injuries he suffered include a concussion, we are told, as well as some lacerations to his face, you see here a picture of the spine, he has also fractured one of his vertebra, in the thoracic area, which is the segment in the middle of his back. The T-9 is the vertebra that he is said to have fractured.

However, the fracture is not so bad he requires any surgery for it. It's the kind of thing that will heal on its own, with some therapy, no doubt. We also understand that he has fractured bones in both of his feet, and he may have to have operations for those injuries.

However, they won't be conducting any operations rather on any of these injuries for sometime, because doctors are saying that he's going to need a couple of days to recover from the concussion, and they can't put him under the anesthesia or anything until his brain recoup rates fully from that particular injury, and once he is past that point, then they can go on and conduct some other surgeries. So that's going to be a few days before that happens, and then it'll be a number of weeks before Priestley can get back to doing some of the things that he wants to do, which would mean, obviously, racing.

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