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Published on May 01, 2011

What Happens When a Trauma is Called? Inside Crozer’s Trauma System

At Crozer-Chester Medical Center, a simple overheard announcement – “trauma activation, 10 minutes” – sets into motion a complex series of activities involving dozens of trained healthcare professionals. Their goal? To save lives. 

Crozer-Chester 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 healthcare 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.

Prehospital Care

That “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.

Getting Ready

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,” Cachecho says.

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.

Crozer’s 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. 

While the 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.

For the trauma team, doing this day in and day out can be stressful.  

“Employees 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.

She adds, “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." 

For more information on the Crozer Regional Trauma Center, call (610) 447-6090 or visit http://crozertrauma.crozer.org.

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