Jaws Of Life Used To Free Lynnfield Woman From Totalled Car

Oldsmobile in head-on collision with lumber truck on Main Street near the high school. Driver alert and conscious after extraction from the vehicle.

A spate of serious car crashes in Lynnfield has now brought the State Police Accident Reconstruction Team to town for what is likely an unprecedented third time in six days.

Shortly before noon on Thursday, an Oldsmobile Cutlass operated by a Lynnfield woman was involved in a head-on collision with a passing truck on Main Street.

The truck was carrying a load of plywood as well as a forklift on the back and the force of the collision was enough to shift part of the load.

The woman was trapped in the vehicle after the crash and safety personnel had to free her using the jaws of life.

However, Lynnfield Police Chief David Breen indicated that the woman had been conscious and conversing when she was removed from the vehicle. Her husband arrived on the scene soon after and she was transported to Mass. General Hospital by a Lynnfield rescue unit.

In the aftermath of the wreck, the motorist was reportedly pinned between the steering wheel and what was left of the rest of the car. Rescuers also had to cut her seatbelt off to free her.

Police were expecting to speak with several witnesses of the accident to further evaluate what exactly happened.

The area of Main Street between the Congregational Church and approximately Essex Street was closed for a couple of hours early Thursday afternoon as State Police finished their work and as the wreckage was cleared from the scene.

The State Police Accident Reconstruction Team was called to Lynnfield in the early morning hours of Monday in response to a fatal one-car crash where a Lynn man was killed after colliding with a parked construction vehicle near the intersection of Salem and Walnut streets.

Before that, a near-fatal crash occurred last Friday afternoon that left a Lynnfield father critically injured and fighting for his life at Mass. General Hospital. A second motorist, a Lynnfield woman, was also involved in the crash but did not suffer life-threatening injuries.


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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5 days ago  ·  

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