A new plan that makes greater use of helicopters to distribute the seriously injured to hospitals across Los Angeles County got high marks Saturday from trauma surgeons who treated victims in the worst mass casualty tragedy since the Northridge earthquake.
Under the plan, victims were airlifted from the Chatsworth crash site to distant emergency rooms, such as at the Ronald Reagan UCLA Medical Center in Westwood, Cedars-Sinai Medical Center near West Hollywood and County-USC Medical Center in Boyle Heights.
Authorities said Saturday that at least 86 of the 135 injured passengers were hospitalized, almost half in critical condition. By comparison, 57 died and 138 were hospitalized in the 1994 Northridge earthquake. In 2005, a Metrolink crash near Glendale killed 11 and sent 140 to the hospital, but the injuries were less grave than in Friday's crash.
The new plan was developed after reviews of the earlier Metrolink crash and the Santa Monica Farmers' Market crash in 2003 that left 10 dead, said Cathy Chidester, director of the county's Emergency Medical Services.
The goal is to ensure that the injured get the proper level of care and to "spread patients out instead of having one hospital inundated" near a disaster scene, Chidester said.
Providence Holy Cross Medical Center in Mission Hills, about eight miles from the site, had prepared for the worst. Notified of the crash by a countywide alert system, the hospital called in additional physicians and nurses. A police escort sped a surgeon to the hospital through rush-hour traffic.
The hospital treated 14 crash victims, five of them critically injured, said Dr. Thomas Waskiewicz, an emergency care physician. The patients suffered head and chest injuries, collapsed lungs, pelvis fractures and broken arms, legs and ribs. "It's pretty clear people were thrown forward or backward at a high rate of speed," Waskiewicz said.
Across the Santa Monica Mountains, the newly opened Ronald Reagan UCLA hospital treated eight crash victims, said Dr. Henry Gill Cryer, chief of trauma surgery. Five needed immediate surgery.
The injuries required 50 units of blood, five times more than the 10 units that usually circulate in a typical adult. Patients suffered internal injuries to the spleen, liver and pancreas, and had rib fractures and other broken bones.
"You can imagine, 40 mph, all of a sudden a train stops and the people keep going," Cryer said.
