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35 people injured, 2 seriously, in 65-vehicle pileup on I-290 West in Worcester

It was an accident unlike any other that Massachusetts State Police Sgt. Stephen Marsh had seen before.

The 22-year veteran of the state police said the only reason the massive 65-vehicle pileup stopped after four-tenths of one mile was because people driving along the westbound side of I-290 were finally able to see the crashed vehicles as they began to drive over the crest of the hill near exit 14.

“The people in the cars under the tractor-trailers, by right, they should have been killed,” Marsh, who is a member of the department’s collision reconstruction section, said Sunday afternoon. “The cars’ roofs were caved into the steering wheels, the fire department had to cut roofs and doors off. Miraculously these people survived.”

Shortly before 7 a.m. Sunday, the temperature in Central Massachusetts dropped, turning precipitation into a freezing rain that created black ice on the elevated section of the highway.

In total, 65 vehicles, including two tractor-trailer trucks and two box trucks, were involved in the accident. About 60 non-injured people were evacuated from the highway by Worcester Regional Transit Authority buses, taken to the atrium at St. Vincent Hospital for warmth and food, to make alternative transportation arrangements and to talk with police about the accident.

Thirty-five people who were injured were taken by ambulance to area hospitals, including St. Vincent and the University of Massachusetts Memorial Medical Center’s university campus.

Marsh said that two people sustained serious injuries — a pregnant woman and a man in his mid-30s. As of early Sunday afternoon, the sergeant did not know the conditions of the woman and man.

A woman with the administrator coordinator’s office at St. Vincent said that of the nearly 20 patients that were brought to the hospital, all but one were treated and released. The single individual not released was transferred to the UMass Memorial Medical Center, she said. She did not provide further information about the patient.

A nursing supervisor at UMass could not comment on patient status when reached Sunday afternoon.

As of 3 p.m. Sunday, nearly 30 people remained in the atrium at St. Vincent waiting to be picked up or continuing to make arrangements for places to stay if they were from out of state.

As Marsh walked in between, and over, the vehicles that littered the westbound side of the highway between mile markers 5.6 and 6 Sunday morning, he saw many out-of-state plates — Ohio, South Carolina, Pennsylvania and Michigan — to name a few. Although it was early for a Sunday, many people were on the road on their way home from the Thanksgiving holiday weekend.

Marsh said that the bad combination of precipitation and below freezing temperature on the elevated bridge deck caused a flash freeze — or black ice — to form. Marsh said that he drove other sections of the highway that were not in such a condition Sunday morning.

Drivers heading west toward Grafton Street could not see the initial accident until after coming over the rise, but by that time it was too late. As drivers applied their own brakes, the vehicles slid, crashing into those in front of them. Trooper Erin McLaughlin, who was responding to an accident in Auburn and had stopped at the initial Worcester accident while on her way, narrowly escaped being hit, Marsh said.

“There was nowhere for her to go. Erin literally dove back into her cruiser just as a car skidded and crashed into the back of the cruiser and the pile up started,” Marsh said, adding that the accident was in an area where jumping over the guardrail onto the roadway below was not an option. Marsh said the trooper was treated and released at a local hospital.

“It looked like something that you see in news coverage from another part of the country when there’s a big storm, not here,” he said of the extensive crash scene.

Marsh said that four cars were crushed underneath one of the tractor-trailer trucks and a Dodge Ram Pickup truck had come to rest on top of some of the other cars. Marsh and six other state police personnel had to climb over vehicles’ roofs and hoods to get to the other vehicles and tend to the most immediate concern: treating the injured.

With the injured transported to hospital and the non-injured safely off the highway, state police personnel began clearing the roadway with help from dozens of tow truck operators.

Massachusetts Department of Transportation highway crews had been on the roadway earlier Sunday, in anticipation of the weather, but the quick change meant that crews couldn’t respond in time, according to Mass DOT Spokesman Michael Verseckes.

Normally, the DOT will notify the private operators that their services might be needed in case of a storm or anticipated weather change, but the sudden freezing rain Sunday morning didn’t afford them the time.

As of Sunday evening, most entrances to I-290 remain closed throughout the city, and traffic was being diverted away from the highway and onto Route 9.

As of 5 p.m. Sunday, the National Weather Service was calling for an overnight low at around 31ºF, and roadways are still wet from the drizzle that occurred throughout the day. It is forecast to rain overnight with fog in the area starting at around 4 a.m. and lasting through the morning commute.

Source: masslive.com WCVB


Nursing Home Negligence

Falls in Nursing Homes

Litigators who work with cases involving long term care know how significant the issue of falls can be. Falls are the leading cause of injury and death by injury in adults over 65. Approximately half of the 1.6 million nursing home residents in the U.S. fall each year, and a report by the Office of the Inspector General found that about 10% of Medicare skilled nursing residents experience a fall resulting in significant injury; and, more than 1/3 of hospital falls result in injury. In the rehab setting, rates are often higher – for example, fall rates among stroke patients have been shown to be very high. Immobility and falls can lead to poor outcomes.

Fear of falling is defined as a geriatric syndrome. It not only occurs in older adults who have fallen, but in those with impaired mobility and is associated with decreased physical ability and depression. Care of older adults requires that clinicians be aware of the myriad of issues related to falls including knowledge of this syndrome, increased risk and interventions needed to prevent injury related to falls.

Just about every resident in a long term care setting, including assisted living and sub-acute rehab, is at risk for falling. Between medications, functional and medical issues and advancing age, older adults in most settings are prone to falling.

There are well established standards of care related to fall prevention; but, as I continue to review records related to issues like falls, I am amazed at how often these basic standards are not being practiced. The basics of a fall prevention program include assessment and ongoing reassessment of risk, ensuring a safe environment, medication review, providing therapy as needed, individualized interventions, and staff education.

Basic nursing practice includes assessment, planning (Care plan), putting interventions in place and then evaluating outcomes to determine if those interventions are appropriate and effective. Assessment includes completing fall risk assessments on admission and then as needed. Very often, the fall risk assessments completed by nurses in LTC are inaccurate. The tools utilized in long term care typically include these risk factors: history of falling, use of ambulatory aids, gait/balance issues, medications, secondary diagnoses (i.e. diabetes) and mental status. Care planning is the next step in nursing care - it is the standard of care that as the resident’s status changes, assessments and care plans must be updated, and often, are not. For example, with each fall, there should be updates, or if there is a new diagnosis, i.e. stroke, or worsening dementia, updated interventions should be put into place, with ongoing evaluation of effectiveness.

Care planning and interventions very often are generic and not individualized. For example, a toileting schedule that includes only after meals and before bedtime may not be appropriate. If a resident has issues with constipation or incontinence, this may lead to the need for more frequent toileting to prevent falls. The “make certain call bell is within reach” for residents with dementia is an example of a generic intervention. Older adults with dementia may not recognize a call bell or remember to use it. The debate about use of bed and chair alarms go on – they are a part of an individualized care plan, not a solution to preventing falls. Often, I see delays in putting interventions in place, i.e. with the resident who is incontinent NOT being put on a toileting plan immediately. The other common issue I see when reviewing records is the lack of updating care plans as the resident’s status changes – with every fall, with worsening dementia, physical decline, or new medical diagnosis (i.e. Parkinsonism).

Nurses reviewing records need to pay attention to the MDS, risk assessments, care plans and Interdisciplinary notes with attention to where the standard of care is not being met.
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7 days ago  ·  

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