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Vanderbilt’s Level 1 Trauma Center celebrates 25 years of saving lives

Posted on Monday, September 9, 2013 at 4:42 pm

Over the past 25 years, nearly 60,000 of the region’s most critically injured patients have passed through the doors of the Vanderbilt Trauma Center, which today celebrates a quarter-century as the region’s only provider of Level 1 trauma care.

On Aug. 30, 1988, Vanderbilt became Middle Tennessee’s designated Level 1 Trauma Center, and to this day remains the region’s only hospital that meets the rigorous standards required to care for the most acutely ill patients. 

Trauma Resuscitation

Vanderbilt Emergency Department (ED) staff and doctors work in the trauma unit on patients brought in by ambulance and life flight helicopter.
(Vanderbilt Photo / Daniel Dubois)

Covering a 65,000-square-mile territory, 58,000 patients have been admitted to the Trauma Center over the past 25 years, including more than 25,000 motor vehicle accident victims, nearly 4,500 gunshot victims, 1,700 stabbing victims and more than 7,000 fall victims, along with a high volume of other injuries ranging from construction accidents to pedestrians hit by cars to recreational accidents.


A ubiquitous disease that can affect anyone, trauma is the leading cause of death in persons under age 44. 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.


However, patients who survive their injuries long enough to arrive alive at Vanderbilt have a 95 percent chance of survival.


Vanderbilt’s trauma patients are cared for by nine board-certified trauma surgeons and eight trauma fellows, along with Emergency Medicine physicians and nurses with the extensive experience necessary 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.”


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.

LifeFlight Landing

LifeFlight makes a landing.


“There is a reason why Vanderbilt stands out as one of the most exemplary trauma centers in the world — teamwork 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.”


This integrated approach to trauma care that today is standard practice at Vanderbilt was pioneered with John A. Morris Jr., 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 over 50,000 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.”


Within six years of Morris’ 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 include five helicopters plus a fixed-wing aircraft and a ground ambulance fleet.


On Aug. 13, 1998, Vanderbilt opened a 31-bed acute and sub-acute care unit that continues to treat a diverse patient population from all walks of life, including country music superstars to farming accident victims, from professional football players to high school athletes.


But Vanderbilt’s trauma service to Middle Tennessee 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 they are in critical condition from a car wreck.”


Trauma care at Vanderbilt, by the numbers:

–          –          Nearly 60,000 patients have been admitted to the Vanderbilt Trauma Unit over 25 years.

–          –          These patients include more than 25,000 motor vehicle accident victims, nearly 4,500 gunshot victims, 1,700 stabbing victims and more than 7,000 fall victims, along with a high volume of other injuries ranging from construction accidents to pedestrians hit by cars to recreational accidents.

–          –          95 percent of trauma patients who arrive at Vanderbilt alive, stay alive. Exsanguination is most often the cause of death in patients who expire in the first 24 hours; those who expire after 24 hours of injury typically do so due to head or spinal cord injury.

–          –          Vanderbilt’s Adult Emergency Department sees more than 60,000 patients annually.

–          –          LifeFlight will celebrate 30 years of service in 2014 and has transported more than 33,000 patients since its inception in 1984. Operating a fleet of five helicopters combined with fixed-wing craft and ground ambulance, it is the only air medical service in the region that carries lifesaving blood.

–          –          Vanderbilt operates the region’s only burn center, with 20 beds dedicated to burn care.

–          –          Vanderbilt has the largest American College of Surgeons-certified Trauma fellowship program in the country and is among the oldest programs nationwide.

Photo Information: Trauma Resuscitation– The Vanderbilt Trauma team treats an accident victim immediately upon arrival in the Adult Emergency Department; LifeFlight Landing– Vanderbilt’s fleet of five helicopters cover a 65,000 square-mile territory