Hurt. Healed. Whole again.
The Trauma Center: 25 years. 58,000 patients. Countless second chances.
About 58,000 critically injured patients have passed through the doors of the Vanderbilt Trauma Center, which recently celebrated a quarter-century as the region’s only provider of Level 1 trauma care.
Every patient and incident is different, but they all have one thing in common. Their lives were dramatically and tragically altered in an instant. Among the more memorable patients in recent years: a well-known singer-songwriter gravely injured in a scooter accident; a law enforcement officer injured in the line of duty; a mother of two who hit a tree while riding a moped without a helmet; a young patient who had a horrific accident while texting and driving and has had to relearn everything like a toddler.
Their stories of survival are a testament to the level of care they received from the moment they became patients of the Trauma Center.
Like a Symphony
In August 1988, Vanderbilt became the first hospital in Middle Tennessee designated as a Level 1 Trauma Center, and to this day remains the area’s only hospital that meets the rigorous standards required to care for the most acute patients.
Covering a 65,000-square-mile territory, the Trauma Center has admitted 58,000 patients over its 25-year lifespan, including more than 25,000 from motor vehicle accidents, nearly 4,500 from gunshots, 1,700 who were stabbed and more than 7,000 injured by falls, along with a high volume of other injuries ranging from construction accidents to pedestrians hit by cars to recreational mishaps.
A ubiquitous disease that can affect anyone, trauma is the leading cause of death in persons younger than 44, but receiving care at a Level 1 Trauma Center can lower risk of death by 25 percent, according to the Centers for Disease Control and Prevention. Patients who arrive at Vanderbilt alive have a 95 percent chance of survival.
These patients are cared for by one of nine board-certified trauma surgeons and eight trauma fellows, along with Emergency Medicine physicians and nurses who are trained extensively to care for the most critically injured patients. This team also works closely with orthopaedic trauma surgeons and subspecialists in neurosurgery, facial trauma, radiology and vascular and spine surgery. Vanderbilt also operates the region’s only burn center, with 20 beds dedicated to burn care.
“We’ve developed a regionalized system that rapidly transports, resuscitates and manages critically injured patients, with the best overall results of saving lives in our region. We are the experts, and we’ve learned how to do this really well,” said Richard Miller, M.D., chief of the Division of Trauma and Surgical Critical Care and professor of Surgery.
“It’s a real collaborative effort, from the time LifeFlight lands on the helipad and continuing between the Emergency Department and our Trauma team;
everyone has a specific role, and it’s like a symphony.”
This “symphony” of Vanderbilt’s trauma care includes a fleet of five LifeFlight helicopters and a world-class Emergency Department that sees more than 60,000 patients annually, providing an integrated approach to care that has been emulated in hospitals nationwide.
“There is a reason why Vanderbilt stands out as one of the most exemplary trauma centers in the world—team work and expertise when treating every patient, every time,” said Corey Slovis, M.D., professor and chair of the Department of Emergency Medicine.
“When I arrived here more than 20 years ago, I was taken aback by how standardized our trauma care was, with every patient treated exactly the same in the initial resuscitation. But over time, I saw the greatness of the Vanderbilt trauma care system. Injuries were not missed, expert care was the rule and was never compromised and younger physicians learned as they worked their way up the system and became exemplary team leaders. Today, doctors, nurses, paramedics, radiology, respiratory, social work, housekeeping and registration all work as a team, every patient, every time.”
The Early Years
This integrated approach to trauma care that today is standard practice at Vanderbilt was pioneered with John Morris, M.D., at the helm.
“We started from ground zero,” said Morris, associate chief of staff of the Vanderbilt Health System, chief medical officer of the Vanderbilt Health Affiliated Network and Vanderbilt’s first director of the Division of Trauma and Surgical Critical Care. “And now, over the last 25 years, we’ve treated nearly 60,000 trauma patients, and we’ve done it in a fashion that I think all of us are proud of clinically, and all of us are proud of our contributions to research and education. We’ve made a significant difference in the community’s care of the injured patient.”
Morris began his tenure at Vanderbilt fresh out of his fellowship in 1984, at a time when the institution had no helicopter, no trauma service, no trauma doctors and no Department of Emergency Medicine. Morris took his first call on July 4 that year and saw no trauma admissions the entire holiday weekend. For perspective, 18 combined Level I and Level 2 trauma patients were brought to Vanderbilt July 4, 2013, alone, with eight admissions to the Trauma Unit. Within six years of his arrival, Vanderbilt was one of only a handful of medical centers in the country to offer a trauma fellowship program. Vanderbilt now has the largest
trauma and acute care surgery fellowship in the nation that meets the American Association for the Surgery of Trauma’s rigorous standards to be a certified American College of Surgeons fellowship, and has trained more than 50 surgeons since 1990, including current Trauma Chief Miller as the program’s first fellow.
Meanwhile, Vanderbilt’s Department of Emergency Medicine was born in 1992, followed by its residency program in 1993, and Vanderbilt’s LifeFlight fleet grew to five helicopters plus a fixed-wing aircraft and ground ambulances. In the early 1990s, critically injured patients were grouped with other surgical intensive care patients, and Vanderbilt’s ICU was becoming inundated with trauma patients. It became evident that the hospital needed dedicated trauma space.
On Aug. 13, 1998, the acute care unit known as the Vanderbilt Trauma Center, located on 10 North in Vanderbilt University Hospital, officially opened its doors. The 31-bed acute and sub-acute unit has treated a diverse patient population from all walks of life.
In an Instant
Years later, the staff of the Trauma Center still recall the patients they’ve treated: a country music star and a professional football player, who were both critically injured in automobile accidents; members of Middle Tennessee’s law enforcement community injured in the line of duty; a rodeo cowboy gored by a bull; a teenager who nearly had his head severed as he was garroted by a wire fence while riding an all-terrain vehicle; an elderly man who suffered a traumatic brain injury after falling from a horse and then having the horse, in turn, fall on his head; and a teenager who had both feet severed by an amusement park ride.
But Vanderbilt’s trauma service to Middle Tennessee and the surrounding area doesn’t stop within its walls, as doctors and nurses regularly conduct prevention and education programs free of charge in area businesses and schools. A Level 1 facility must be able to provide leadership and total care for every aspect of injury, from prevention to rehabilitation, which means Vanderbilt’s trauma program is continuously learning and looking at ways to improve performance across disciplines and enhance communication between specialties.
“Our ongoing mission is to provide optimal care for our community, leading the way in medical education, research and high-quality patient care,” Miller said. “Our patients are regular people, who one minute were going to work or having dinner, and the next minute are in critical condition from a car wreck.”
These “regular people” include six trauma survivors who share their stories of hurt and healing and the painful process of becoming whole again. Click here to read their stories.
Click below to view a time lapse video of a busy night in the Emergency Room on New Year’s Eve 2013.