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CNN LIVE EVENT/SPECIAL

Rhode Island Hospital News Conference

Aired February 21, 2003 - 11:14   ET

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

DARYN KAGAN, CNN ANCHOR: We're going to go ahead and join the news conference live now instead of tape. Let's listen in to the doctors at the hospital.
(JOINED IN PROGRESS)

DR. WILLIAM CIOFFI, SURGEON-IN-CHIEF, RHODE ISLAND HOSPITAL: For most burns, it's small. For some of these patients that didn't get here for two hours, it increases slightly. But right now, I don't think that we have a patient that I would consider at serious risk of kidney failure.

QUESTION: So pneumonia is the result that the endangers the victim most directly for smoke inhalation?

CIOFFI: After we get through the first 24 hours, yes.

QUESTION: Fourteen of the 38 patients are in critical condition, yet you said 18 are incubated (sic) and on a respirator.

DR. JOSEPH AMARAL, PRESIDENT, RHODE ISLAND HOSPITAL: Right.

QUESTION: Can you...

AMARAL: Because there are patients who are intubated who we wouldn't consider critical.

QUESTION: Why are they incubated (sic), then?

AMARAL: They are intubated. They have a tube for breathing, but their airway injury isn't of sufficient extent for us to consider it critical, and we would anticipate that they would be being weaned off the ventilator fairly quickly.

Initial response is -- you're intubating a lot of people and being as safe as you can to protect them, because in a situation like that, you can't wait for something to happen.

QUESTION: Describe the hospital's response this morning. I hear you trained for this type of disaster?

AMARAL: I thought -- I mean, I was incredibly impressed. Imagine the situation, where phone call. People come in. They move patients out of places where they are to make room for patients that are coming in. These people are all treated, and they're in a room in two hours. The staff here did an incredible job. That includes the nurses, respiratory therapists, housekeeping, everybody in positions. So it was pretty amazing. It does come from the training. It comes from being a level one trauma center, being used to deal with situations, not of this magnitude, but you get the same response. It's just sort of -- I keep saying that, in order to get a good response, it's got to be a response that you use all the time. It's really pretty impressive.

QUESTION: Was the triaging at the scene fairly effective? It seems like you didn't move too many people once they came here.

AMARAL: Yes, I can't really comment on that. Wasn't there and don't know. We got 63 patients. I can't speak to the methodologies used.

QUESTION: Were you concerned that you had several people too many here, and that's why you were sending them to MGH?

AMARAL: No. We sent patients to the MGH because treatment of burn patients is a very intensive treatment. There's only so many that you can treat. You follow? There's only so many resources here that we can utilize to treat. So at a certain point, you need to be balancing what the resources are available in the region to best treat these patients. So those are the decisions being made. Rhode Island Hospital isn't capable of taking care of, for example, 20 patients with 50 percent burns. Most places aren't. So there are systems in place to regionalize the care.

QUESTION: ... other patients transferred, were those transferred to Massachusetts?

AMARAL: Those went to Mass General. Yes. They went to Massachusetts General Hospital.

QUESTION: So there is a total of eight there now, doctor?

AMARAL: There may be more. We don't know. We have sent eight there, and Dr. Cioffi has been in contact with them routinely.

QUESTION: ... elaborate a little bit more on what the scene is in the intensive care unit? How many patients does it hold, and where in proximity are their family members?

AMARAL: Sure. Can you just rephrase that for me, or just tell me again. I didn't catch -- I didn't hear all the pieces.

QUESTION: In terms of the intensive care unit, are all the patients in one particular area? Are they spread out around the hospital? Where are they?

AMARAL: No, they're pretty much all coalesced. The patients are in the trauma intensive care unit, and all the burn patients are in there in the step down unit, which is right next to that, and we have some patients in the surgical intensive care unit. That's all on one floor. We also have less critically ill patients, still critically ill in the medical intensive care unit, and then all the other burn patients are on one unit by B, which was -- patients were moved out of there during this process to get everybody in, so that essentially two floors of the hospital function is for all these burn patients. So that's all coalesced together, which is not only good for the patients, it also is good for the staff in terms of taking care of them.

QUESTION: ... care unit maxed out at this point as far as number of patients?

AMARAL: I'm sorry?

QUESTION: Is the intensive care unit maxed out as far as number of patients?

AMARAL: No. We still have -- we do have some capacity. Now, we've used -- we're utilizing that for the elective surgical schedule that's going on today, and we do have a couple of beds open that we have open.

QUESTION: You said every patient we know has a survivable injury. Were you speaking strictly of the patients with the burns, or also with the smoke inhalation? Was that a general statement...

CIOFFI: With both. I think that every patient has a reasonable chance of survival.

QUESTION: Can you describe what a patient with burns would go through as far as treatment?

CIOFFI: The first 24 hours is going to be a matter of stabilization and fluid administration and some simple burn wound care, just cleaning of the wounds and the application of antibiotic ointment to the wounds. And then starting on about the third day, we will start bringing the patients to the operating room, where they will undergo removal of their -- of the dead skin and skin grafting, and we will stage that depending upon the patient's severity of injury.

And after that, they'll have dressing changes, and we'll get the wounds healed, hopefully get them off the ventilator, and then they'll start a rehabilitation process. The more severely injured patients, this is going to be a process of months, and for the less severely injured, maybe one or two weeks.

KAGAN: All right. We've been listening in to the hospital news conference in Rhode Island talking about the large number of people that were taken there after the night club fire in West Warwick. About -- more than 50 people have been declared dead after that fire, 168 people were injured.

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