Docs Expected Few Survivors in SF Plane Crash

July 11--Dr. Dimitriy Kondrashov was at Golden Gate Park with his 3-year-old daughter when he got the text from his wife.

"There was just a crash at SFO," she wrote.

He called his hospital, St. Mary's Medical Center. A resident there hadn't heard anything about a crash.

Another text from his wife flashed across his phone.

"The pictures of the plane are horrible," it read. "I can't imagine anybody survived."

Kondrashov, an orthopedic spinal surgeon, dropped his daughter at home and rushed to the hospital.

The hospital was already crowded with staffers. Some had stayed on at the end of the shifts; others just showed up after hearing the news.

Of the more than 180 people hospitalized after the crash of Asiana Airlines Flight 214 at San Francisco International Airport on Saturday, St. Mary's received five of them.

Kondrashov headed straight for a patient with a spinal injury. The injury surprised him, he said. He had seen images of the charred plane.

"I thought there'd be burns. I frankly didn't expect that many orthopedic injuries," he said.

His patient was bleeding and immobilized by severe pain in his neck and back. Through a Chinese translator, Kondrashov asked the man to move his fingers and toes. They wiggled. He wasn't paralyzed.

Kondrashov discussed his case with the patient's approval, but he didn't want his name to be made public.

S.F. General

At San Francisco General Hospital, Dr. Payal Kohli was in the lab when another doctor burst into the room.

" 'A plane just crashed at SFO' " was all he said," recalled Kohli, a cardiology fellow. "Everyone just dropped everything they were doing."

The hospital shifted immediately into crisis mode. Updates and emergency instructions blared over the hospital public address system. It was "organized chaos," Kohli said.

She prepared mentally and physically for multiple, life-threatening cardiac emergencies that the emergency room might send her way. In crashes like this, she said, cardiac injuries are almost always life-threatening.

"We expected the worst," she said.

The closest trauma center to the crash, S.F. General received the most severely injured passengers. As patients began to stream into the hospital, Kohli filtered through the cardiology patients, mostly those with arrhythmias and possible cardiac contusions.

Many patients were discharged quickly, but some were in critical condition. On Wednesday, three patients remained in critical condition, including one child.

Stanford Hospital

Down the Peninsula, Stanford Hospital also prepared for an onslaught of patients. Dr. Robert Norris expected the preparation would end up little more than a cautious exercise.

"I thought we're all going to get ramped up and there weren't going to be any survivors," said Norris, chief of the Division of Emergency Medicine.

It was clear it was going to be a different kind of day when news filtered down that fire and rescue workers were triaging 290 passengers at the crash site.

The hospital cleared any patients they could out of the emergency room. A triage center was set up in the ambulance bay. Within 27 minutes the hospital was ready.

Patients began flowing in, by helicopter, ambulance and bus. Adrenaline was chugging through the staff, but everything remained calm. The first of the 55 patients had the worst of the injuries.

By 10 p.m., though, Norris was on his way home. The hospital had quieted; the crash was not the disaster it could have been.

"In emergency medicine, we train for the worst trauma," said Norris. "Most of the people were miraculously well."

Kristen V. Brown is a San Francisco Chronicle staff writer. kbrown@sfchronicle.com @kristenvbrown

Copyright 2013 - San Francisco Chronicle