Life-saving ER techniques are helping to reduce the city's murder rate

Published: Sep. 11, 2013 at 8:47 PM CDT|Updated: Sep. 18, 2013 at 10:44 PM CDT
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New Orleans, La. - When looking at the murder rate in New Orleans, it's important to understand not only how many victims died, but how many lived through live-threatening attacks.

According to the New Orleans Police Department, there were 97 murders from January 2012 to June 2012 and 77 murders from January 2013 to June 2013. However, the number of assaults was nearly the same: 756 in 2012 and 755 in 2013.

Doctor's at the area's only Level 1 trauma center believe their team is playing a role in helping people survive assaults.

When a patient's life is on the line, he or she is wheeled directly into the care of 30 doctors at the Spirit of Charity Trauma Center at Interim LSU Hospital.

"Somebody described it as organized chaos, but there's nothing chaotic about it. It's an organized team," said Dr. Norman McSwain Jr., the center's trauma director.

In what's known as "Room 4," McSwain says the team will do 2,000 major resuscitations a year.

"We have a dedicated team that does it over and over and over again," he said.

He said the response will always look the same whether the patients are injured in a rollover car accident or an assault.

"When a patient comes in, you hear very little noise, you hear very little talking, because everybody's got a job, everybody knows what their job is," said McSwain.

Over the past few years, those jobs have changed slightly.

"We have adopted the resuscitation scheme that was developed by the U.S. military," said McSwain.

Now, the techniques used to keep military personnel with traumatic injuries alive in Iraq and Afghanistan are being employed in New Orleans.

Along with a systematic approach by the doctors, it comes down to the fluids patients are given. Instead of a water formula that contains electrolytes called chrystalloids, more patients are receiving blood and plasma transfusions, which doctors say makes patients bleed less.

"We found about a 50 percent drop in mortality rate if we used blood and plasma as a resuscitation fluid and not chrystalloids," said McSwain.

He says Interim LSU Hospital has been leading the way by using this military technique to save lives.

"We were the very first people in the U.S., in the world, to publish a civilian paper on resuscitation using blood and plasma," said McSwain.

It's what McSwain believes is driving the survival numbers up. More survivors means a lower  murder rate, even while assault numbers have remained consistent.

For both the first half of 2012 and the first half of 2013, the same number of patients were admitted with gunshot wounds: 251.

In 2012, 40 of those patients ended up dying. In 2013, 27 died.

When you add accidental, suicidal and miscellaneous gunshots, the trend looks the same.

Forty-five patients died from all gunshots at the trauma center during the first six months of 2012, compared to 34 in 2013.

"And we know that those outcomes can still be improved on as we improve our system of care," said Dr. Peter Deblieux, director of emergency medicine services at the LSU Interim Trauma Center.

The hope is that more patients will survive no matter what brings them through the doors of the emergency room.