New Year’s Eve eight o’clock. Twelve-year-old Joep arrives at the emergency department of Gelre hospitals in Apeldoorn with his mother and sister. He had gone racing in a car with older friends. When the car got stuck in a sand hill, his hand got stuck “somewhere”. Emergency nurse Marleen Stegeman must first determine whether there is a serious injury. On the edge of the bed, the boy mainly looks at the clock. “I actually want to be home before twelve o’clock to light fireworks.”
Ultimately, there appears to be only a fracture. Stegeman attaches a sling. “You’re a tough one,” she says and gives him a rocket ice cream because his blood sugar is a bit low.
Joep has a sore hand due to an accident with a car.
Photo Eric Brinkhorst
Half an hour later it is still quiet in the emergency room. In the coffee room, nurses warm up leftovers and eat an oliebol. That rest is temporary, the nurses and doctors know that. A night shift on New Year’s Eve is always busy and intense. Apeldoorn has had a fireworks ban since New Year’s Eve 2020, but they hardly notice it in the emergency department. “People are together longer and sit together all evening,” says nurse Stegeman, who has been working in the emergency room for 23 years. “They are on the road, outside, exercising more, using drugs, drinking more. And then there are fireworks.”
We used to see mainly heavy firecrackers, now many Cobras
Busyness is not unusual in the emergency department. “In the event of a major accident on the A1, it could also be full here at once,” says surgeon Anton Gijsen. That’s part of it. “We don’t get stressed about that.”
However, the staffing has been scaled up on New Year’s Eve: four nurses are working this night instead of three. The fireworks have become heavier over the years, and therefore the injuries become more serious. “We used to mainly see heavy firecrackers,” says Stegeman. “Lots of Cobras now.”
During the New Year’s Eve, 1,162 fireworks victims across the country ended up in the emergency department or at the emergency department of general practitioners. Almost half of them did not set off any fireworks themselves. The hope is that a possible fireworks ban next year will limit the number of victims and thus relieve the pressure on healthcare.
Typical for the holidays
At nine o’clock several patients report with lung complaints. “They are bothered by the soot and fireworks in the air,” says nurse Sandra Burger. People come in after a fall due to too many drugs or alcohol. An older woman asks if she can stay, at least then she won’t be so alone. Meanwhile, nurses help patients with a piece of meat stuck in their esophagus. “Typical for the holidays,” says nurse Aniek van Ark.
The New Year’s Eve night is busy for the emergency room staff in Apeldoorn.
Photos eric brinkhorst
There is smoked salmon on the table in the coffee room, a nurse walks around with a plate of crostinis with cucumber and brie. Shortly before the start of the service, the request was shared in the group app to bring something tasty. “And then we hope there is time to eat it,” says ER nurse Ilona Groothedde, laughing. There is a previously untouched glass of non-alcoholic bubbly on the desk.
A little later, the caregivers run to the doors of the emergency room. A fireworks victim. A fireworks pot – legal fireworks – had not gone off. When checking the fuse, the fireworks exploded in my face.
The room suddenly smells like ash. People waiting at the doctor’s office avert their eyes. In the crash room, intended for seriously injured people, eight caregivers gather around the bed within seconds. They work according to the ABCDE method: a fixed sequence to quickly see whether someone can breathe, is getting enough oxygen, has no dangerous bleeding and is conscious. What is most life-threatening receives attention first.
With fireworks, the first image can be misleading, Stegeman explains. “The force of the explosion continues, sometimes deeper into the body and is not immediately visible.” The family has only just arrived when the decision is made to transfer. The injury is so serious that the patient is taken to the trauma center in Zwolle.
Little effect
Shortly afterwards, Apeldoorn mayor Ton Heerts arrives with a box of chocolate to “encourage” the doctors and nurses. Just before that he also dropped off a box at the fire brigade. He has also seen that the local fireworks ban has had little effect so far. “Enforcement remains complicated,” he says.
He hopes that a national fireworks ban will make more of a difference, precisely because not only lighting off but also the purchase of consumer fireworks will become a punishable offense. “I can imagine that it deters hobbyists,” says Heerts. “Because then you could get a criminal record.”
Amid all the hustle and bustle, there is room for snacks, a reception from the mayor and a toast to the new year.
Photos eric brinkhorst
The nurses who are on duty on New Year’s Eve are normally relieved at ten o’clock. This is currently not possible due to the fireworks victim. Even later in the evening when they are relieved so that they can go home before midnight, no one is ready to leave. “The grief of the family and friends hits home hard,” says Stegeman. “It feels strange to walk into the festivities now.” After the debriefing and the transfer from the evening shift to the night shift, it is almost time to ring in the new year.
It’s almost midnight. The night shift hurriedly pours non-alcoholic bubbles into plastic glasses. At midnight there is time to toast. Five minutes later, most of them are back in the emergency room.
Around half past twelve, an NL alert goes off on several telephones: 112 is overloaded. The emergency notification with which the Dutch government can warn everyone via mobile phone is rarely sent nationally. An ambulance worker who walks in out of breath says that the ambulance was stopped several times on the way to the hospital. “People stepped onto the road, waved and shouted for us to stop.”
On the fist
The military police take up position in the hallway around three o’clock. Two groups that fought with each other and were injured are taken to hospital at the same time. They are still stirred up.
Most parties are over, but the procession of patients is growing: more fireworks injuries are passing by, people with shortness of breath, injuries after a fight.
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Would that decrease next year if the ban continues? Emergency care providers doubt it. “We are actually afraid that people will simply get the fireworks illegally,” says Aniek Van Ark. Trainee doctor Marcus Meijer from the ER hopes that it will become more difficult for children, “they are less likely to ask their parents to drive abroad for fireworks.”
“I hope it rains tomorrow,” says nurse Gerda Batenburg. “Then the fireworks will get wet and they can no longer go off. Then hopefully we will see fewer children here tomorrow who have been playing with them.”
Healthcare providers doubt whether it will be less busy next year.
Photo Eric Brinkhorst
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