MUSC Level 1 trauma center wins re-accreditationby Cindy AbolePublic Relations Every six minutes, someone, somewhere will experience a life-threatening injury. Every few seconds, someone, somewhere will be hurt with a disability injury. In the precious seconds that follow these types of emergencies, receiving immediate care and accessing the right level of acute care services and treatment can affect the balance between life or death. Lowcountry residents should consider themselves fortunate because in September, MUSC won reaccreditation with South Carolina Department of Health and Environmental Control (DHEC). MUSC's 24/7 trauma care services met criteria and standards that ensure care from the most highly-skilled practitioners, staff and medical technology available to treat acutely injured patients. MUSC is one of four Level 1 trauma centers in the Palmetto State capable of handling the most severe injuries and life-threatening situations. They are part of a statewide trauma system dedicated to providing effective, coordinated care from the time of a patient’s injury to recovery. MUSC joins Palmetto Health Richland in Columbia, Spartanburg Regional Medical Center and Greenville Memorial Medical Center as the state’s four accredited Level 1 trauma centers and among 20 other hospitals and medical facilities that make up the state’s trauma care network. All are focused on a common goal: providing the highest level of quality patient care. “Level 1 trauma centers commit an enormous amount of resources, funding and personnel to provide the best quality medical services while helping to keep the state’s trauma system afloat,” said Phyllis Beasley, program coordinator with SCDHEC. “MUSC is the only Level 1 trauma center located in their region of the state. In S.C., trauma accreditation is a voluntary process within the state’s trauma care network. We appreciate the commitment MUSC has undertaken as a valuable resource in trauma care. It’s through their commitment that the state’s trauma system keeps going.” Providing and maintaining this level of trauma care within the state’s most comprehensive medical center is a concerted effort not concentrated in one department, but shared by many teams of acute care specialists, medical staffs and departments throughout the hospital, according to Debbie Couillard, R.N., MUSC trauma coordinator. “A trauma center is not a hospital’s emergency department just as an emergency department is not a trauma center,” said Douglas Norcross, M.D., trauma surgeon in the Department of Surgery. “A vast majority of medical care is provided by professions and teams outside of a hospital’s emergency department. The emergency room is just the foyer or entryway inside a vast structure of skilled staffs, specialization and care. A successful trauma center is truly a hospitalwide effort.” Within trauma medicine, practitioners recognize “the golden hour” paradigm of care. It is a concept that defines the critical time after a patient suffers from a serious injury. If a patient receives prompt medical care and is stabilized, his chances for survival can triple, reducing his chances for long-term side effects related to the injury. A patient’s outcome depends upon the timeliness of an initial medical response, combined with the availability of a specialized trauma center and its services. But providing these specialized services continues to be a challenge within an evolving process. From 1974 when DHEC was initially granted the authority to organize and coordinate statewide emergency departments, to 1993 when MUSC opened its first emergency room, the changes and demands in this field have been fast-paced. Threatened by rising care costs and challenged by non-existent funding support, trauma hospitals and their supporters must continually speak up and communicate the many issues associated with trauma care in South Carolina. With the help of Norcross and other statewide advocates, the legislature passed the S.C. Trauma System Act in 2003. Today, Level 1 trauma care enlists a multidisciplinary team approach
involving trauma physicians, surgeons, medical specialists, nurses, X-ray
and lab technicians, therapists and other skilled personnel. The daily
challenge is operating and maintaining this level of care to all trauma
patients.
An important part of the re-accreditation involved a site visit by an out-of-state trauma review team held last June. The team, composed of a trauma surgeon, emergency physician and trauma nurse coordinator, assesses everything from patient outcomes and care to staff education and training, injury prevention outreach and other research efforts. For example, Level 1 trauma staff are required to maintain their skills through specialty continuing medical education training, trauma nurse courses (nurses), and advanced trauma and critical care life support training (physicians). In addition to staff training and services, Level 1 hospitals must supply around-the-clock services of a trauma surgeon, physicians, an operating room, blood bank facilities and other hospital services to handle critical emergencies. Blood Bank Transfusion Services manager Nancy Reilly knows what’s involved in preparing for a trauma emergency. “Our team is committed to maintaining a 24-hour blood storage facility and safe blood products to patients at any time,” said Reilly, emphasizing the everyday readiness of her team due to the stringent requirements by inspecting agencies for supplying and maintaining blood products. “It's our job to be ready to meet whatever need is required of a patient, especially following a trauma.” Reilly and Couillard meet regularly to discuss and communicate needs and evaluate the system to make changes if necessary to always improve the process. The same level of open communication, care and commitment occurs between surgery, intensive care staffs, pharmacy, rehabilitative personnel and numerous other medical specialty staffs to coordinate trauma care at all levels throughout the hospital. For now, Norcross, Couillard and other supporters will continue to work
closely with the state’s Trauma System Advisory Board, the SC Hospital
Association and SC DHEC towards continued advocacy while seeking to secure
state funding for the trauma system. Beyond that, they will collaborate
in creating new regulations to help guide the network’s accreditation process
and continue to promote the presence of a trauma care system among the
public to provide immediate, life-saving care.
Skilled trauma services save retiree’s lifeFor almost 52 years, Allyn Aksomitas enjoyed a strong, active, independent life. A retired Air Force officer, he had spent the last two years working on his 50-foot catamaran.On Sept. 28 he and his friend were ready to launch his boat into the water for the first time. Then things went wrong. The boat teetered and pinned Aksomitas. The boat slid into the water, dragging Aksomitas with it. Everything happened so fast, the next thing Aksomitas knew, he was dogpaddling towards the sea wall. His friend held a ladder down to him, then pulled him out. “The accident is still fresh in my mind,” Aksomitas said. “I felt like a piece of dough being rolled by a rolling pin.” His body had been squashed and crushed from his sternum to his feet. Within minutes of the accident, EMS arrived and took Aksomitas by ambulance to MUSC’s Level I Trauma Center. Once Aksomitas arrived, the trauma team was ready to work. “There were at least 15 people around me, putting in IV’s, ready to give me a CAT scan,” he said. “I had already lost 3.5 liters of blood. I was impressed by how prepared the trauma team was. There was no stress or panic. I had a strong sense that they were going to be able to take care of me no matter what. Their expertise and preparedness saved my life.” Aksomitas was treated by the skilled hands of several MUSC physicians and staff. In surgery, they cut Aksomitas from his sternum to his crotch so they could check and stabilize all internal organs. He suffered busted ribs and intestines, an acute testicular trauma, a broken hip and a fractured femur in his left leg. His mesenteric artery, which supplies blood to the intestines, burst. The skin and underlying tissue around his torso and leg area had separated from his muscles. “The trauma system saved my life,” Aksomitas said. “Having a Level I
trauma center so close saved me. They were ready to handle the extent of
my injuries. If I had lived an hour away from the nearest trauma center,
I would not have made it.”
Friday, Jan. 14, 2005
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