THE VIRGINIAN-PILOT
Copyright (c) 1994, Landmark Communications, Inc.
DATE: Sunday, October 2, 1994 TAG: 9409300240
SECTION: CHESAPEAKE CLIPPER PAGE: 02 EDITION: FINAL
COLUMN: Random Rambles
SOURCE: Tony Stein
LENGTH: Medium: 89 lines
The emergency room at Chesapeake General Hospital handles an average of about 4,000 cases a month. That, says the brass at Chesapeake General, makes it the busiest emergency room in Tidewater.
They're not sure why it's so busy. Maybe, they say, it's the blast-off growth of the city. Maybe it's the location of the hospital on the main drag from the Outer Banks of North Carolina.
I have a suggestion: people seeing Chesapeake's City Hall for the first time are taken ill and need immediate medical attention. Just kidding, architecture fans.
No kidding, emergency rooms are serious business. Dr. David Pitrolo knows. He's been an emergency room physician for 11 years, eight of them at Chesapeake General.
He's seen pretty much the whole range an emergency room doctor can see, from overanxious mamas with sniffling babies to the bloody aftermath of drunken driving and arguments that end with gunshots. He finds it endlessly challenging, frequently exciting and - sometimes, at least - frustrating, because no doctor can mend every broken body.
A 41-year-old Philadelphia native, Pitrolo took his degrees at West Virginia University. He got hooked on emergency medicine as a resident physician moonlighting in a hospital emergency room. ``I liked the intensity and the diversity,'' he says. ``I liked the challenge of having to react properly at a critical moment.''
He joined the emergency room staff at Maryview Hospital in Portsmouth in 1983 and came to Chesapeake General in 1986. He's part of an eight-doctor group that staffs the emergency unit, each doctor working about a 10-hour shift. That may not be your comfortable 9-to-5, but it beats the heck out of his residency days, when he might spend 36 hours straight either on duty or on call.
Heart attacks are among the most common of the serious cases he sees, Pitrolo says. When a patient's heart isn't beating, he or she is immediately hooked up to a monitor. Maybe the heart is doing what's called fibrillating. That means it's quivering, but not pumping. The problem calls for electric shock therapy. You're seen it on the TV medical shows. The doctor administering the therapy says, ``Stand clear!'' and everyone backs off while the heart muscle is jolted.
Standing clear isn't just a casual precaution, Pitrolo says. ``If someone is touching the patient's body while the electricity surges, we might have two stopped hearts instead of one.'' If the shock treatment doesn't work, there is chest massage.
There is a medical battle plan for trying to bring back a patient with a stopped heart. It's called ACLS, for Advanced Cardiac Life Support, a combination of medicines, shock treatment and cardio-pulmonary resuscitation. And all the while, the battle is fought against the clock. The brain needs the oxygen carried in the blood. If it doesn't get the oxygen because the heart is stopped, brain tissue begins to die after about seven minutes. Each case is different, but seven minutes is a ticking bomb.
How long the doctors and nurses keep up the fight varies with each case. Pitrolo knows of one that lasted an hour because the heart kept sputtering into life and quitting.
Losing the fight is a hard loss to take, Pitrolo says. ``You're brought up against the realization that there is only so much you can do. Then you have to go out and tell the family, probably absolute strangers, that someone they love is dead.''
Because it hurts so much to lose, Pitrolo treasures those special victories he and the other doctors and nurses at the emergency room have won. Like the heart attack victim revived to get on with a normal life. Or the ruptured spleen that could well have been fatal but was mended. Or the child choking on a bead until it was spotted deep in his throat and removed. Pitrolo beams as he talks about those cases, and he wants it known that skillful paramedics are a critical part of the medical team.
For those of you who think helmet laws for motorcycle riders and seat belt laws for drivers are mean ol' Big Government trampling your rights, listen to the doctor who has to put the pieces back together:
``We used to see lots of cases where people were thrown forward through the windshield and cut their faces terribly. It would be so sad. We see a lot less of that since the seat belt laws. Helmet laws have cut down on head injuries, too.''
But that average of 4,000 cases a month tells you that there are still plenty of times when the emergency room doors burst open and paramedics wheel in someone who needs help right now. Stress is always there.
Ask Pitrolo how he beats the stress factor and he'll say that sailing is a good emotional refuge for him. There's something else, too. Dave Pitrolo has the satisfaction of knowing that he and the doctors and nurses who are his colleagues have made a difference in the lives of a lot of people. by CNB