All posts tagged night

My Night in the Emergency Room – Aish

I was in my kitchen following directions for a new muffin recipe when the immersion blender got stuffed with the dried ingredients, clogging the sharp blades. For a second I thought to myself, let me unplug the machine, but somehow I didnt.

I know. Big mistake.

I put my finger in to scoop out the thickened flour and before I knew it the machine went swirling. I screamed out for my husband to call Hatzalah, the emergency volunteer corp. Grabbing a towel, I wrapped it tightly around my finger. We ran outside, my hand lifted, pointed to the sky.

A few moments later we heard the sound of sirens. My husband and I climbed into the ambulance. I was afraid to look and turned away as my finger was examined. No doubt about it, I needed to get to a hospital. I kept giving my husband a brave smile but the truth is, I had no idea about how much damage was done. I was frightened and scared. And yes, it was painful.

The Hatzalah volunteers raced us to a nearby hospital. They brought us in to the emergency room and reassured us that all will be all right.

All around me there were people waiting to be helped. Police were clustered around a room where they were guarding a crime victim with a gunshot wound. Some lay moaning on their stretchers. This is going to be a really long night, I thought to myself.

The Hatzalah crew took care of getting me checked in and quickly returned with news.

The doctor on call tonight is a wonderful plastic surgeon. Hes part of the local community and guess what his specialty is? Hands!

I was overwhelmed with gratitude.

I cant believe it, my husband added. I know him. We grew up together and went to the same shul as kids.

Even more unbelievable because the shul is in Sao Paulo, Brazil.

I was settled on a stretcher still holding up my heavily bandaged finger while we waited for the doctor who was treating another patient.

My husband began pacing. Is the pain terrible? he asked.

Its ok. I gave a thin smile.

So many thoughts were going through my head. Why didnt I just unplug that machine? What was I thinking? Who knows what this will involve? And wow, does this ever hurt!

Then I remembered something my mother taught me years ago. When Joseph was sold by his brothers and taken down to Egypt, he was put into a caravan. Normally, there would be smelly tar taken as the caravans cargo but to spare Joseph the awful stench, God arranged that on this journey there would be fragrant spices instead. When Joseph would smell the spices hed realize that he was not forgotten. This would be a personal sign to him. Even in the midst of his pain and suffering, he was receiving a comforting message from Above.

At this moment I truly got it.

In the midst of your pain, look for a sign and seek a token of something good. Try to smell the sweet spices and youll get through your challenge feeling loved despite the pain.

Here we are in this emergency room, I said to my husband. Its the middle of the night, were both exhausted and I have no idea how this will turn out. But with it all, I feel comforted. The doctor here is a plastic surgeon hand specialist whom you grew up with! What are the odds? I am smelling the sweet spices. I am feeling the Almighty watching over me.

A short while later the doctor treated me and thank God I my hand will heal without lasting damage. We were finally ready to return home.

It had been a difficult day. That morning we had stood in the cemetery for the unveiling of my beloved mother, Rebbetzin Esther Jungreis. Prayers were recited and tears were shed. Even though the distance from that tragic moment of loss grows wider, the searing pain remains. I yearn for another conversation, another laugh, another Shabbos meal shared, another blessing that will never be.

But if we can hold onto the lessons that a parent has given us, then the soul is forever with us, guiding us, inspiring us, and infusing us with strength. That is the parents legacy.

That night my mothers words echoed to me in the night, bringing me comfort and soothing my soul.

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Tough question for hospitals: Who’s too risky to release? – Auburn Citizen

NEW YORK Four days before Alexander Bonds ambushed and killed a New York City police officer, he was in a hospital emergency room getting a psychiatric evaluation. The hospital released him the same day.

Now the hospital’s actions are under a state review ordered by the governor. St. Barnabas Hospital says it handled Bonds appropriately and welcomes the inquiry.

The decision was one psychiatrists across the country make regularly: whether patients pose enough danger to themselves or others to require hospitalization. Practitioners say that it’s often a difficult call to make and that even an experienced evaluator can’t predict someone’s behavior.

“Most of the time, it’s very complicated. You’re trying to make an assessment: Is the person going to a home? Is there family? Are they reliable? What was the specific reason they were brought in? Is that likely to occur again?” said Bea Grause, president of the statewide hospital and health system association HANYS and a former emergency room nurse.

Bonds, 34, evidently had a history of mental health problems. There were antidepressant and anti-psychotic medications in his apartment, and his girlfriend told officers she took him to St. Barnabas for the psychiatric evaluation July 1, police said.

He was observed for seven to eight hours in the emergency room, where he was seen by a physician and then a psychiatrist, hospital spokesman Steven Clark said.

“We believe the proper protocols and standards were met,” he said.

By the night of July 4, Bonds’ paranoid, erratic behavior worried his girlfriend enough that she called police to look for him. They didn’t find him before he marched up to a parked police vehicle and shot through the window just after midnight, striking Officer Miosotis Familia in the head. Soon after, officers shot and killed him after they say he drew a weapon on them.

The state Health Department said it plans to interview St. Barnabas staffers, conduct inspections and examine records to review Bonds’ case and the hospital’s policies and prescribing practices.

Under state law, people can be involuntarily hospitalized for at least 48 hours if they pose a substantial risk of causing serious injury to themselves or others.

“If you’re making a determination that someone’s a danger to themselves or others, you better be pretty clear about it. Because you’re taking away their liberties,” said Grause, whose association represents hospitals and nursing homes.

Psychiatrists caution that the risk can be difficult to pinpoint.

“While psychiatrists can often identify circumstances associated with an increased likelihood of violent behavior, they cannot predict dangerousness with definitive accuracy,” the American Psychiatric Association said in a 2012 position statement.

Doctors and other hospital staffers can encounter agitated emergency room patients they’ve never seen before.

While paying close attention to what patients say and do, doctors also might test to determine whether a medical problem or medication might be spurring the behavior. They consider whether the cause could be alcohol or illegal drugs, a clue sometimes illuminated by observing patients for hours. They may look into whether someone has dementia.

Some patients arrive clearly violent, and others are just having a bad drug reaction that will wear off. But “there’s this vast gray area in the middle that takes a lot of experience, a lot of knowledge and balancing all of the factors that go into a good assessment,” said Dr. Vivian Pender, a New York City psychiatrist and public affairs representative for the New York County Psychiatric Society.

Police have been working to determine Bonds’ motive in shooting Familia. Bonds, who had served prison time for a 2005 armed robbery, had railed about police and prison officers in a Facebook video last September.

Familia, 48, was a 12-year New York Police Department veteran and a mother of three. She was selfless, “incredibly funny” and full of warmth and wisdom, her 20-year-old daughter, Genesis Villella, said Friday.

She “went to work every day proud to do her job, to protect us,” Villella said.

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Local emergency room sees influx of patients around 4th of July – WHSV

ROCKINGHAM COUNTY, Va. (WHSV) Many of us got to enjoy the fresh air on the night of Independence Day as we admired the firework displays happening around the Valley. However, some folks missed out, spending their evening in the emergency room instead.

According to WalletHub, 800 people go to the emergency room with firework-related injures each Fourth of July, and 67% of all fireworks-related injuries happen within a month of July 4th.

Over the holiday, the emergency department at Sentara RMH Medial Center experienced an influx of patients who were admitted with injuries related to fireworks.

Monday was the busiest day with 211 patients overall. On the Fourth of July, 161 people were admitted.

Brandy Sollenberger is the clinical nurse manager in the emergency department at Sentara RMH. She said the majority of folks were suffering from burns, but a few cases were more severe.

“They’ve all been kind of similar, very, very similar with hand injuries mostly. Hand and upper body,” said Sollenberger.

She added that those who needed surgery were taken to UVA Medical Center.

“From one careless second. It can only take a few seconds and if they’re not known anyone who’s been injured before or seen the impact of fireworks, the danger that they have, they’re going to take that chance because they want to celebrate,” said Sollenberger.

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Investigates: VA calls veterans ‘imprudent,’ denies ER payments – KARE

A.J. Lagoe & Steve Eckert , KARE 10:21 PM. CDT June 12, 2017

As a service-connected disabled veteran, Ben Krause expected the Minneapolis VA would automatically pick up his $6,066 hospital bill. He was mistaken. (Photo: KARE 11)

MINNEAPOLIS Thousands of veterans every year are saddled with medical debt they shouldnt owe some of it even turned over to collection agencies after trips to the emergency room.

A KARE 11 Investigation discovers its happening, in part, because the Department of Veterans Affairs does not consistently apply its own rules.

A Tough Night

When you are parents of a newborn, there can be a lot of sleepless nights. But for Ben and Gretchen Krause, one night last February stands out.

It was a tough night, thats for sure, recalled Ben. It was the night he spent hours in a Woodbury, Minnesota emergency room.

The idea of losing him, Ben, with a little baby here – it was really scary, said Gretchen, fighting back tears.

Ben says he began experiencing severe chest pain and was struggling to catch his breath.

I felt like my chest was about to pop, he said.

I remember he said, ‘Something’s wrong,’ said Gretchen. Something’s wrong!

Fearing her husband was having a heart attack, Gretchen grabbed the baby out of bed and drove the family to the emergency room at HealthEasts Woodwinds Hospital. They spent the next nine hours there.

Doctors determined that instead of a heart attack, Ben was having an extreme form of stress likely exacerbated by a recent death in the family.

Technical term for it is malignant hypertension with neurological and cardiovascular complications, Ben explained. I couldnt dial back the stress from what was going on in the grief process.

As a service-connected disabled veteran, Ben expected the Minneapolis VA would automatically pick up the $6,066 hospital bill.

He was mistaken.

The Prudent Layperson Denial

I got a letter in the mail saying they were going to deny me, said Ben.

Bens case raises the question, just what does the VA believe is a prudent laypersons definition of an emergency?

To find an answer, KARE 11 looked to the VAs Prudent Layperson Fact Sheet.

The letter, which appears to be a boilerplate form, said Ben was being denied reimbursement for his visit to Woodwinds Health Campus because, The treatment provided does not meet the Prudent Layperson definition of an emergency.

Apparently, a prudent normal guy wouldnt have gone to the emergency room if they were experiencing chest pains, exclaimed Ben sarcastically. A normal layperson would have just sat on the couch, I guess.

The Fact Sheet describes a prudent layperson as someone:

possessing an average knowledge of medicine and health, to believe that his or her condition, sickness, or injury is of such a nature that failure to obtain immediate medical care could result in placing the patients health in serious jeopardy, cause serious impairment to bodily functions, serious dysfunction of any bodily organ or part, or in the case of a behavioral condition placing the health of such person or others in serious jeopardy.

Gretchen Krause maintains she and her husband did what anyone would have done when facing a similar situation.

Im not a doctor, Im not a nurse, she explained. I know when to go to the ER. You go to the ER when someone is in distress, and he was in distress!

While many veterans might have concerns about challenging the VA denial, Ben Krause happens to be one of the nations most prominent and outspoken veterans rights attorneys.

Ben likens the VAs letter to bad faith insurance denials. This is straight out of the insurance company 101 books on how to deny a claimant, he said.

In fact, KARE 11 discovered the VAs own guidelines spell out an example of when a veteran was acting prudently when they visited an emergency room even if the final diagnosis turns out to be something less serious.

Case Example A describes a patient who goes to the ER complaining of chest pain but is given a diagnosis of mild gastric irritation.

The VAs Prudent Layperson Fact Sheet goes on to state that because chest pain is a potentially serious problem it clearly falls into the category of what any prudent layperson would consider an appropriate use of an emergency department.

When you look at it this, it is almost verbatim your case, KARE Investigative Reporter A.J. Lagoe said to Krause while reading the VA Fact Sheet.

Right, Krause laughed. Its black and white and it is Case Example A!

This is spot on exactly what I experienced, Krause said. Chest pains, going to the emergency room. Im not a doctor! How am I going to know whether Im truly having a heart attack or not?

The idea of losing him, Ben, with a little baby here – it was really scary, said Gretchen Krause of the night she had to bring her husband to the ER. (Photo: KARE 11)

Systemic Pattern

KARE 11 wanted to know, is Krauses case an isolated problem, or a systemic pattern of dubious denials?

If it happened to me, I guarantee its happening to thousands of veterans nationwide, Krause said.

He is right.

During a Congressional hearinglast year, VA Assistant Deputy Undersecretary for Health for Community Care, Dr. Baligh Yehia submitted written testimonyabout veterans being denied payment for emergency room visits.

That statement shows between the beginning of fiscal year 2014 and August of 2015, approximately 98,000 claims were denied because the condition was determined not to be an emergency.

Dr. Yehia wrote, Many of these denials are the result of inconsistent application of the ‘prudent layperson’ standard from claim to claim and confusion among Veterans about when they are eligible to receive emergency treatment through community care.

He added, When denied, the financial responsibility for these claims, which can be substantial, often falls on Veterans

Its absurd, said Krause who wrote about his imprudent layperson denial on his popular veterans blog.

In his article, he served notice to the VA he was working with KARE 11 to get to the bottom of his claim denial.

VA Reversal

The same day KARE 11 emailed the Minneapolis VA asking for an interview to discuss the case, Krause says he received a call from an official saying a mistake had been made and his claim should not have been denied.

The second that they realized that somebody was looking into it, and somebody with the ability to make it into a national story, once they realized that, then they called and said, Oh sorry, we made a mistake, were going to take care of it.

Minneapolis VA officials refused to be interviewed for this report.

However, in an email they blamed the denial on a coding error by the non-VA emergency room that treated Krause. They also stated that at the time of the initial denial, VA did not yet have all his records.

It appears the denial letter was issued without anyone at the VA contacting either the private hospital or Krause to determine the nature and cause of his hospital visit.

The VA spokesman confirmed that Krauses entire claim for emergency medical care is now being covered.

Even so, Krause questions how many other veterans have the ability to quickly get the VAs attention without going through the appeals process, which often takes up to five years.

If you dont have the ability to get your story out there, he said, I mean, youre not going to get the justice you need.

Our investigation started after a tip from a viewer. If you have a suggestion, or want to share records of your VA Emergency Room Claim, email us at: investigations@kare11.com

2017 KARE-TV

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Emergency room nursing shortage looms for county – NRToday.com

I definitely foresee a nursing shortage.

Todd Luther is the Emergency Room director at CHI Mercy Medical Center in Roseburg and he sees a big change in the next 10 years as the most experienced nurses in the ER at Mercy transition out and newer nurses are picking up the load.

There are openings in the Mercy ER department and they expect more in the near future.

Theres limited access to nursing programs across the state, Mercy human resources director Deb Lightcap said.

The Umpqua Community College nursing program has been a major player in supplying nurses to local hospitals and providers, and in most years, Mercy will hire the bulk of the new graduates out of UCC because of the high demand.

The UCC nursing program has about 150 students apply each year. But there are only 48 openings, which is about the same as it has been for the last few years, according to April Myler, the Director of Nursing at the college. Most of those students have jobs as soon as they have the degree.

We have a greater than 90 percent job placement, said Myler. Those who do not go straight to work are often working to further their education, working toward a Bachelor of Science in Nursing or Master of Science in Nursing. Many students have job offers before they graduate.

Some nurses start their career in the ER, but recruitment coordinator Kelly Richardson said most of the time, they work their way into that unit after gaining experience in other areas.

There is a huge critical care nurse shortage right now, said Richardson. The emergency room, intensive care unit, the pulmonary care unit, those are our most difficult areas to fill at the moment.

She said some will start their careers in acute care and work a couple of years, and then move to the emergency department, but there are some nurses who will start in the ER.

Lightcap said thats not always been the case. In the past, when they brought in new graduates, the first job was usually the night shift on the medical floor. But with the shortage getting more acute now, she said, there is such a need that organizations are thinking differently about how they can bring new grads into their facilities, and get them into more critical areas.

Were constantly looking at our on-boarding and most importantly our orientation program because we need to assure individuals are competent and successful, so the orientation into our ER and ICU is far more extensive and longer than our orientation to our medical floor, Lightcap said.

The problem though is that they can only take so many graduates in a particular area because you want to have a good complement of experienced nurses and new nurses in that mix.

Lightcap said Mercy is looking for experienced nurses to hire, and that has been difficult to attract to this area.

Housing is a challenge for us. It depends on what the spouse needs to have, so its tough to compete with bigger markets, she said. For us our focus is on quality of life, smaller community, no commuting, good place to raise kids, the pace and the beauty we have here, and youre looking for someone who is looking for that.

If they get to the point where they dont have enough people to cover all the shifts, they do have other options. They can hire agency nurses and they have done that, but their preference is to not have to do that.

The agency nurses are contracted for 13 weeks and will bring emergency room experience, but normally will not stay past the end of the contract.

Our desire is to not rely on agency nurses because its not someone you can acclimate into your culture because theyre not going to be there for a long time, Nightcap said.

Mercy is looking at building a resource pool that would have people that could go to different departments when needed there.

One of the things we really focus on, when were getting new staff in our department is trying to find experience, which is a huge challenge, said Angela Felker, the clinical coordinator for the Mercy ER.

Luther said his focus is on how to keep that skill set that the experienced nurses have in the ER now. He said when you lose the top of the skill set, you have to figure out how to bring in others to fill that void.

So thats what were really struggling with right now. Were working to make sure were not caught with our eyes closed when that happens, because we know its going to happen, Luther said.

Felker said its a great profession to get into for someone who is thinking about a medical career, and there is high demand right now. She encourages people who are interested to enter the profession.

Its an amazing career. I love what I do every day. Im thrilled to be a nurse, we can make a big difference in very stressful times, Felker said.

And its not just a female-dominated career anymore. Myler said the majority of students are still female, but the number of men applying and being accepted into the program continues to increase.

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Blue Cross Blue Shield To Launch Emergency Room Policy – WABE 90.1 FM

Starting in July, health insurance provider Blue Cross Blue Shield will stop covering emergency room visits it deems unnecessary.

And doctors and analysts have a lot to say about it.

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Blue Cross Blue Shield is enacting this policy because it doesn’t want people to use the emergency room as their primary health care.

“The cost of care’s been going up so much faster than people’s earnings. We have got to find a better way to do some of this stuff, taking some of that unnecessary spending out of the system,” says JeffFusile, president of Blue Cross Blue Shield.

Fusile says BCBS wants patients to use urgent care, retail health clinics and their LiveHealth app, which are all cheaper than an ER visit.

“What this policy is directed at is regular, run-of-the mill colds, maybe even influenza. But you don’t need to go to the emergency department to get tested for whether or not you have the flu and to get a Tamiflu prescription,” says JasonHockenberry, who teaches health policy at Emory University.

Hockenberry says, in his research, he’s found many people often use the emergency room inappropriately, for urgent care rather than emergency care.

“This is a real problem. Emergency departments are expensive; they’re there for a different reason. Blue Cross is clearly staking a claim here that we’re going to try to change patient behavior,” Hockenberry says.

Donald Palmisano, president of the Medical Association of Georgia, paints a different picture when it comes to this policy: Imagine a BCBS member has chest pains in the middle of the night. He thinks it might be a heart attack, so he goes to the ER. But it turns out that it was just indigestion. Under BCBS’snew policy, he gets charged for using the emergency room inappropriately. So the next time he has chest pains, he thinks, in case it’s just indigestion, he won’t go to the ER. But this time, it’s a heart attack, and he dies.

“Blue Cross is clearly staking a claim here that we’re going to try to change patient behavior.” – Jason Hockenberry

“That’s where our physicians are concerned. Because they’re like, you know, you’re putting the patient, who doesn’t have the clinical background, to determine whether their condition is of an emergency nature,” Palmisano says.

Palmisano says this policy also might disproportionately affect the elderly, those living in rural areas and adolescents over the age of 14.

“I have four children, and if there’s an injury and it’s hard to determine the pain they’re experiencing, it’s hard to determine whether to go to the emergency room or not. It puts that added stress because you’re dealing with a loved one and you’re putting parents in a very difficult situation,” Palmisano says.

But FusileofBCBS says he knows, in medicine, it’s not always black or white.

“There are lots of gray areas where the diagnosis wasn’t so bad after all, but you have to look at the situation the person was in at the time they were in it,” Fusile says.

Remember that scenario about the man who thinks he’s having a heart attack, but it’s just indigestion? Fusile says that falls into the gray area, too. He says a panel of doctors will assess claims to make sure everyone’s getting fair coverage.

But Palmisano and Hockenberry say they’ll have to wait until the policy is implemented to see how effective it really is.

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Manchester bombing: We treated kids whose names we didn’t know, doctor says – USA TODAY

Queen Elizabeth II on Thursday visited in hospital some of the children injured in the Manchester terror attack which killed 22 people. Video provided by AFP Newslook

Staff at the Royal Manchester Children’s Hospital stand next to donations made to a charity connected to the facility on May 25. The donations are for the families and victims of the Manchester attack as well as for the doctors and nurses treating them.(Photo: Kim Hjelmgaard/USA TODAY)

MANCHESTER, England Doctor Steve Jones didn’t have a lot of information. He didn’t know why there was an explosion. He didn’t know much about singer Ariana Grande. He didn’t know the children who came into his emergency room, bloodied and crying.

But there was one thing he did know: It was time for him to try and save lives. Even if he didn’t know their names.

“The anonymity of it was also hard,” said Jones, a surgeon at Central Manchester University Hospital NHS Foundation Trust. “Some of the kidswere separated from their families for a time. We were treating children and we just didn’t know who they were.”

The horror of Monday night’s bombing in Manchester, which left 22 dead and over 100injured, is particularly difficult for doctors and emergency personnel. Many of Ariana Grande’s fans are young people, and many of the concert-goers were teenagers or even younger, accompanied by their moms, sisters and brothers.

Related:

Manchester bombing: Ariana Grande’s stage manager recalls explosion, pandemonium

It made the tragedy even more palpable for Jones and his fellow doctors and nurses, who struggled with some of the most difficult injuries to treat: Blast wounds. In children, no less.

Jones wouldn’t reveal specific details about the injuries, thought to include amputations, damage to major organs and serious head injuries, but he did offer some observations about what it was like to respond to Britain’s worst terrorist-relatedatrocity ina decade.

“The kid thing is particularly tricky,” he said. “As a doctor, it’s easy to be in the moment, you can do things, but the real difficulty that we’ve all felt with this incident is that it’s not just one child, and the ‘you can go off and have a cup of tea and have a chat with a friend’ it was the volume and severity of it.”

Joneswas roused from a deep sleep at home just before 11 p.m. on that night. The hospital was asking if he had heard the news.

He hadn’t. He was also not familiar with Grande’s music. His first thought was that the injured would probably be adults. He wasn’t sure how long he would be neededand or ifhe would need to rest in between. He took along a sleeping bag just in case.

When he arrived at the ER, part of a campus of medical facilities that includesthe Royal Manchester Children’s Hospital, he was surprised to see so many families and kids.

Many of the 116 people who sustained injuries in Monday’s attack atManchester Arena were treated in the emergency rooms that Jones presides over. Seventy-five people are still receiving careacross eight Manchester hospitals. Eight children remain in a critical condition. At least six children were killed in the blast.The youngest,Saffie Rose Roussos, was 8. All thevictims of the attackhave now been identified.

Jones said the injuries his staff treated that night are fairly typical of blast trauma, or, as he puts it, the “consequences of lots of things flying around.”

He said that the team of doctors he manages performed so well that he was able to spend most of the night comforting families. “I say ‘thank you’ a lot in this job,” he said, referring to how proud he was of his team’s clinical response to the attack. “On this particular occasion, ‘thank you’ just doesn’t seem enough.”

Surgeon Steve Jones in Manchester on May 25.(Photo: Kim Hjelmgaard/USA TODAY)

Investigators believe that the explosive materialsused in the bomb detonated by22-year-old Salman Abedi were the sameas those used in terrorist attacks in Brussels and Paris, and in the 2005 bombings in London. The bomb was packed with nuts and bolts to cause maximum damage.

When Queen Elizabeth visited the Royal Manchester Children’s Hospital on Thursday to meet patients and praise the hospital’s staff, she described Monday’s incident as a”wicked” act. “The awful thing was that everyone was so young. The age of them,” she said.

During the visit, Grant Barlowtold the queen how when his daughter Amy, 12, suffered injuries to her legs outside the concert hall a man selling T-shirtsripped them up to help stem the bleeding. “He used the T-shirts as bandages,” Barlow told her.

When USA TODAY visited a charity that is connected to Royal Manchester Children’s Hospital, there were piles of donations stacked up against a wall. Mostly small bags and containers ofpotato chips, cookies and sweets, but also toiletries, bottles of water and other consumables.

Sarah Naismith, the charity’s director, explained that many people from around Britain have been eager to help. “Firemen, students, companies, they’ve all been calling up saying ‘whatever you need, it’s yours.'”

Britain’s Queen Elizabeth II speaks to Amy Barlow who was injured in the Manchester Arena terrorist attack along with her mother Kathy during a visit to the Royal Manchester Children’s Hospital.(Photo: Peter Byrne, AFP/Getty Images)

“Everyone’s felt that they needed to do something. It’s been an emotional roller-coaster,” she said.But Naismithfought back tears when asked how she was doing.

“I have three children and to think of the horror that people saw, you can’t fathom it.” she said.

Soon afterNaismith finished speaking, Manchester resident Simeon Gunningstopped by to donate some cases of soup and other goods.

“I thought it would be helpful,” he said. “Me and a couple of friends put a little money together and just tried to do what we could, to help the families.”

Gunning said that “as a (regular) person” he felt a little powerless in the face of all thecarnage.

“You can’t really do anything to help fix their injuries, so what can you do besides put your hand in your pocket and try to do something that way?” he said. Then he added, “Manchester Strong,” anecho of the “Boston Strong slogan that popped up in reaction to the Boston Marathon bombing in April 2013.

For Dr. Jones, there was recognition that Manchester, its victims and its healers, would be dealing withthe consequences of the attack for some time.

“This is not an ‘on’ and ‘off’thing,” Jones said.

As for the sleeping bag that he brought to the hospital Monday night? By the time he left the next morning at 10 a.m., he hadn’t used it.

RELATED COVERAGE

Manchester bombing: Trump orders leak investigation as Brits halt intelligence sharing

Neighbors of Manchester bomber Salman Abedi recall him as abrasive, anti-social

Manchester bombing victims: Loved ones identify all those who died in concert attack

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New Senior Emergency Center at Atrium Medical Center expands services for older adults – WCPO

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