What Happens When a Trauma is
Called? Inside Crozer’s Trauma System
(Editor’s Note: This is another in
a series of articles commemorating the 25th anniversary of the
Crozer Regional Trauma Center.)
- Crozer-Chester Medical Center is home to the Crozer Regional Trauma Center, the only trauma center in Delaware County.
- When the medical center learns that a trauma patient is coming, it sets into motion a complex series of activities involving dozens of trained health care professionals.
- The patient goes from the site of the injury to the Emergency Department for life-saving care. Once stabilized, the patient may receive testing, go to the Operating Room or be admitted to the medical center for inpatient care.
Crozer-Chester Medical Center, a simple overheard announcement – “trauma
activation, 10 minutes” – sets into motion a complex series of activities
involving dozens of trained health care professionals. Their goal? To save
Medical Center is home to the Crozer Regional Trauma Center, the only trauma
center in Delaware County. The Trauma Center is not actually a physical place,
but rather a system led by a team of specially
trained physicians, nurses and other health care professionals who are
available 24 hours a day, seven days a week to care for traumatic injuries.
Since 1986, the professionals of the Crozer Regional Trauma Center have cared
for more than 35,700 patients. The Trauma Center presently treats more than
2,500 trauma and burn patients each year.
“trauma activation” announcement begins when an EMS professional calls medical
command to alert them that a potential trauma patient is on the way to the
medical center either by helicopter or ambulance from both Crozer-Keystone and
local providers. When someone
suffers a traumatic injury, it is important to ensure that a patient arrives at
a trauma center as quickly as possible – the goal is within 60 minutes, which
is known as the “golden hour.” If transportation is being made via ambulance,
patients benefit from the experience and advanced training of Crozer-Keystone’s
EMS professionals, who are trained in Advanced Trauma Life Support. They
are able to secure a patient’s airway, protect the spine and, most importantly,
rush the trauma victim to the Trauma Center. While
the patient is being transferred, the
trauma team provides guidance to the transport team to ensure the most
effective care for the patient.
But what constitutes a trauma? A trauma is a serious
injury that is caused by an outside force. The two main types of traumatic
injuries are blunt traumas, which are caused by impact or other force applied
by a blunt object, or penetrating traumas, in which the body is pierced by a sharp object. Contrary to what
some may believe, only about 10 percent of Crozer’s trauma patients are victims
of violence and the remaining are involved in traffic accidents or falls, according to Riad Cachecho, M.D.,
medical director of the Trauma Center.
Through the overhead announcement and pages, the trauma
team knows that a patient(s) is on the way, and when the patient is expected to
arrive. Within five minutes of the announcement, this essential group of
professionals knows that they must arrive in the trauma area in the Emergency
Department to prepare for the patient’s arrival. Crozer’s state-of-the-art
Emergency Department contains four dedicated trauma bays with a range of
equipment needed to care for severely injured patients. Based on what is known
about the patient’s injuries, the team may also bring in additional equipment.
This initial team that responds consists of a
comprehensive range of professionals, including a trauma surgeon, an Emergency
Department physician, an anesthesiologist, residents, Emergency Department and
Trauma nurses, trauma service physician extenders, Radiology staff, a
representative of the Blood Bank, a radiology technician, a social worker and more.
The trauma surgeon serves as the team’s leader. Crozer
maintains a trauma surgeon on-site at all times. “Although we are not required
to do this, we feel that it is important to provide the very best care,”
When the patient arrives at the Emergency Department, he
or she is rushed into one of the trauma bays. The EMS professional provides the
trauma surgeon with a brief overview of the patient’s injuries and condition.
When the patient arrives in the trauma bay, the team’s
first goal is to save the person’s life. “When a patient arrives, the team’s
main focus is to care for the patient’s immediate and potentially
life-threatening injuries,” Cachecho says. “We are fortunate to have an
experienced, highly skilled team that has the expertise to care for a variety
of injuries as well as the ability to work quickly and efficiently under
extreme pressure. They are truly life-savers.”
How good is Crozer’s team? About 95 percent of trauma
patients who come to Crozer alive leave the medical center
alive, a survivor rate above national averages.
Once a patient is stabilized, the team may
have the patient undergo testing, be sent to the Operating Room for surgery
and/or admitted to the Shock Trauma Unit for ongoing care. Crozer offers the
necessary equipment and systems to provide this ongoing care.
In terms of diagnostic imaging, Crozer’s Emergency
Department offers a 64-slice computed tomography scanner, allowing caregivers
to obtain diagnostic information quickly and efficiently.
If surgery is needed, one room in the Operating Room is
always available to care for trauma patients. “The trauma surgeon makes the
call about whether a patient will need an operation. In addition to our
dedicated trauma surgeons, we are also fortunate to have several skilled
surgical specialists on call to care for specific injuries, including anesthesiologists, orthopedic surgeons,
neurosurgeons and cardiothoracic surgeons,” Cachecho says.
Shock Trauma Unit is a dedicated 15-bed intensive care unit for our most critically
injured patients. It is directed by trauma physicians and staffed by eight
trauma nurses and a nurse trauma practitioner with the specialized training and
experience required to provide the intensive care needed by these patients. The
team conducts daily rounds of patients on the unit. As a result of this
dedicated approach, Crozer’s Shock Trauma Unit has reduced patients’ length of
stay in intensive care.
patient is being cared for, other members of the trauma team are playing important
roles. “Our social workers, for example, are very important members of our
team. In many cases, the patient’s family members are dealing with a
devastating injury to their loved one. They are skilled in helping family
members come to grips with what’s happening and to prepare them for what’s to
come,” says Debra Lillback, R.N., director of the Trauma Program.
trauma team, doing this day in and day out can be stressful.
also can be impacted by what they see and what they have to do for trauma
cases. Because of this, we take the time to let employees talk about their
feelings and handle their stress by having debriefings,” Lillback says.
“We have a great team who loves what they do and does an outstanding job caring
for the most critically injured people in our community.”
information on the Crozer Regional Trauma Center, call (610) 447-6090 or visit http://crozertrauma.crozer.org.