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Frequently Asked Questions


Auto Safety

My 74-year-old mother has been in several minor car accidents. I am concerned that she is going to be seriously injured, or injure someone else. Is there anything I can do?


My orthopedic doctor told me my leg was broken, the nurse said it was fractured. Why the discrepancy?


Is it true that seatbelts can cause injury if you are pregnant?


Chest Trauma

What is a Concussion?


I was told not to fly on a plane after sustaining rib fractures and a partial collapsed lung. Why is that?


Since receiving ER treatment for injuries from an auto accident, I have had a sharp pain in the right chest when I sneeze, should I be concerned?


Coma

When someone is in a coma from brain injury, can doctors predict when they will wake up?


Gift for Guns Program

Baystate sponsored a gun buyback program this year and last, why is that?


Level 1 Trauma Center

Why is it that most serious auto accident injuries go to Baystate?


Neck Trauma

I was in a rear-end collision and since that time I have pain with movement of my neck. My doctor took x-rays and said there were no broken bones, so why does it still hurt?


Orthopedics

My orthopedic doctor told me my leg was broken, the nurse said it was fractured. Why the discrepancy?


Spleen Removal

Someone I know was injured and had to have their spleen taken out. Isn't the spleen an important organ?


Auto Safety

My 74-year-old mother has been in several minor car accidents. I am concerned that she is going to be seriously injured, or injure someone else. Is there anything I can do?

Dr. Lisa Patterson says:

Losing the ability to drive may feel like loss of independence. You need to approach this subject with compassion.

  • Start by asking your mother if she is having any difficulty driving, and how she thinks she is doing.
  • Make sure she has had a recent physical and eye exam.
  • Check out your local elderly service organization for transportation options.
  • Lastly, there are driving advisement programs that will evaluate and make recommendations regarding your mother’s ability to drive safely.

 

There is a good brochure with information on the subject called “We need to talk… Family conversations with older drivers” available at www.thehartford.com/talkwitholderdrivers.


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My orthopedic doctor told me my leg was broken, the nurse said it was fractured. Why the discrepancy?

Dr. Lisa Patterson says:

The medical definition of a fracture is a break in the bone, so technically both are correct. Fractures can be small, such as a “hairline” fracture, or can be severe such as comminuted (broken into several pieces). The severity depends on many factors such as: which bone, where in the bone the fracture is, how displaced the pieces are, involvement of nearby joint, etc.

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Is it true that seatbelts can cause injury if you are pregnant?

Dr. Lisa Patterson says:

The purpose of the seatbelt is to restrain the bony skeleton and prevent ejection from a vehicle. Once ejected, the chance of being killed in a collision increases tenfold.  Seatbelts must be worn properly to minimize risk of injury from the belt itself.  The lapbelt should be worn low, over where a person bends at the hips; therefore, there is no difference in how it is worn when pregnant.  The shoulder harness should go across the shoulder, not the neck.  Without a seatbelt, a person is thrown forward in the car, which risks impact into the abdomen of a pregnant woman and cause severe injury to the baby and mother. So wear your seatbelts!

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Chest Trauma

What is a Concussion?

Dr. Lisa Patterson says:

Concussion is the term used to describe a mild traumatic brain injury. Typically a patient will have had a brief loss of consciousness and a head CT scan will be normal.  The symptoms can range from minor to severe. The most common symptoms are headache, dizziness, nausea, vertigo, memory difficulty, trouble concentrating, irritability and difficulty sleeping.  Repetitive blows to the head can cause additive brain injury, and prevention is key (e.g. helmet use).

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I was told not to fly on a plane after sustaining rib fractures and a partial collapsed lung. Why is that?

Dr. Lisa Patterson says:

The reason for limiting flights in commercial airlines is the fact that the cabins are not pressurized to sea level. In effect, while flying at 32,000 feet the cabin pressure may be equivalent to being at 8,000 ft.  At altitude, air in closed spaces expands (ever notice the tight bag of potato chips on a flight?). With a pneumothorax, which is air outside the lung but within the chest cavity, an increase in the size of the air can lead to potential breathing difficulty.  Most trauma surgeons restrict commercial flight for several weeks, to assure that the lung injury has healed and the pneumothorax is resolved.

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Since receiving ER treatment for injuries from an auto accident, I have had a sharp pain in the right chest when I sneeze, should I be concerned?

Dr. Lisa Patterson says:

Sharp focal pain with rapid movement of the chest wall (such as coughing, sneezing, laughing) is typical with rib fractures. Rib fractures are very common and can occur with any blow to the chest.  They can’t always be seen on xray.  Unlike an extremity, there is no cast applied. Binding the ribs is not indicated, as it inhibits breathing deeply, and therefore can lead to pneumonia. The treatment is pain medication, and education.  The pain typically lasts 6-8 weeks, and is associated with movement of the affected ribs. Because the back, abdominal and shoulder muscles all attach to the ribcage, daily activity can be significantly limited.

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Coma

When someone is in a coma from brain injury, can doctors predict when they will wake up?

Dr. Lisa Patterson says:

The best predictor of outcome that we have is the Glasgow Coma Scale (GCS), a universal system that rates the severity of brain injury based on the person’s ability to open their eyes, speak and move.

 

The scales score ranges from 3, which is completely unresponsive, to 15, which indicates the patient is awake and oriented to person, place and time.

 

The lower the GCS initially, it is less likely the person will survive the injury. Unfortunately, there is no way to predict the length of coma or the long-term disabilities associated with traumatic brain injury for those that survive.

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Gift for Guns Program

Baystate sponsored a gun buyback program this year and last, why is that?

Dr. Lisa Patterson says:

Injury prevention is an important community effort for Baystate as the area’s only level I trauma center. Having a gun in the home significantly increases the chance of injury and death of an occupant in that home by suicide, accidental or intentional use.

 

The gift for guns program is a city collaboration to assist in getting unwanted guns out of homes, particularly those with children.

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Level 1 Trauma Center

Why is it that most serious auto accident injuries go to Baystate?

Dr. Lisa Patterson says:

Baystate is the regional level I trauma center serving all of western MA and the border areas of other states, particularly CT and VT.  Level I means the most seriously injured patients are taken or transferred to Baystate, where 24 hour critical resources are available, including immediate OR and surgical capabilities. Baystate sees > 2000 seriously injured patients/year. The most common mechanism of injury is motor vehicle collisions. Patients with serious injuries get admitted to the Trauma Service which coordinates care from multiple subspecialties.

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Neck Trauma

I was in a rear-end collision and since that time I have pain with movement of my neck. My doctor took x-rays and said there were no broken bones, so why does it still hurt?

Dr. Lisa Patterson says:

You probably have cervical strain, commonly referred to “whiplash”. When the head is whipped back and forth in a collision, this can cause tearing of neck muscles which makes them painful to movement.  Anti-inflammatory pain medicine such as Ibuprofen is helpful, as well as heat and massage.  If severe, sometimes physical therapy and muscle relaxants are necessary. If neck pain is associated with any numbness or tingling, this may be a sign of more severe neck injury and medical attention should be sought immediately.

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Orthopedics

My orthopedic doctor told me my leg was broken, the nurse said it was fractured. Why the discrepancy?

Dr. Lisa Patterson says:

The medical definition of a fracture is a break in the bone, so technically both are correct.  Fractures can be small, such as a “hairline” fracture, or can be severe such as comminuted (broken into several pieces). The severity depends on many factors such as: which bone, where in the bone the fracture is, how displaced the pieces are, involvement of nearby joint, etc.

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Spleen Removal

Someone I know was injured and had to have their spleen taken out. Isn't the spleen an important organ?

Dr. Lisa Patterson says:

The spleen is an important organ in the body’s defense against germs, bacteria and infections. It is part of your immune system and its function is to filter out old blood cells, damaged cells and bacteria from the blood stream. Bacteria with capsules in particular are filtered out the spleen.

 

When the spleen is removed (splenectomy), patients are given vaccines against the bacteria with capsules, and need updated vaccines every 10 years. The spleen is only one part of the immune system, so other parts of the body help fight off infections.

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