Archive for May, 2015

Trauma Systems Hold Key to Disaster Response

Wednesday, May 27th, 2015

An Interview with Dr. Ronald Stewart, Chair, ACS Committee on Trauma

The high speed Amtrack train derailment in Philadelphia that killed eight people and injured 200 this month is the type of event that keeps Dr. Ronald Stewart up at night. As chair of the American College of Surgeons Committee on Trauma, Stewart’s mission is to maintain and strengthen the nation’s trauma system infrastructure so that it can respond to such mass casualty events in the most effective manner possible.

In the case of the Amtrack Northeast Regional Train 188 crash on May 12th, the system worked well, and first responders were prepared. Just one day before the crash, the city’s Office of Emergency Management had held a “mass casualty workshop” with police, fire and health personnel—providentially putting trauma system functioning top of mind for all those who would be called into service the next day.

Within 15 minutes of the crash, an Emergency Operations Center was activated; and within an hour, dozens of firefighters and paramedics were on the scene, rescuing and triaging train passengers. Throughout the night and into the morning, more than 200 people were transported and treated at hospitals, with responders taking the most seriously injured to Temple University Hospital.

Encompassing communications systems, emergency response teams, coordinating agencies, trauma centers and personnel, regional trauma systems are not uniformly present or functional across the United States. Stewart, who is also chair of the Department of Surgery at UTHSCSA, remarked that there is a tremendous difference in the ability to respond in regions with and without a functional trauma system. A system like the one activated in Philadelphia, that gets disaster victims to the right level of care in a sufficient amount of time is not uniformly available. He emphasized the key element is “timely, structured cooperation and communication.”

“Functioning trauma systems in the United States respond well to everyday, small to medium-sized disasters like multiple automobile vehicle crashes,” said Stewart. “But a large-scale disaster requires more coordination than a routine traumatic injury, and not all systems are prepared for such an event. Integrating disaster response into a trauma system dramatically helps with preparedness.”

The ACS establishes standards for trauma systems, promotes high quality trauma care and advocates for the location of trauma centers in areas of greatest need. In a recent position statement, the organization warned that health care economics may interfere with trauma center allocation, with an oversupply in more profitable areas and a dearth in less financially desirable locations. Such market-driven allocations are detrimental to the long-term stability of regional trauma systems and the populations they serve, noted Stewart.

“History has shown that market forces are insufficient to guarantee a stable system,” said Dr. Robert J. Winchell, Chair of the ACS Trauma Systems Evaluation and Planning Committee in a press release on the matter issued by ACS. “Police, fire and EMS services are not provided based on market profitability; the same criterion must be held true for trauma services.”

Importantly, Stewart also noted that improvements to pre-hospital prevention, response and care will have a bigger impact than improvements made to any other part of the system. “In-hospital care can still be improved, but this care has come a long way, and the chance of survival is very high if a trauma victim arrives alive to a tertiary trauma center,” he said.  “A 10 percent improvement in hospital care will lead to a certain number of lives saved; but a system-wide 10 percent improvement in pre-hospital care will likely have a much greater impact.”

Read the Press Release from ACS regarding its position paper on trauma center designation.


Univ of Pittsburgh Trauma Researchers Develop Promising Computer Simulator

Tuesday, May 12th, 2015

A University of Pittsburgh research team headed by Yoram Vodovotz, Ph.D., professor of surgery and director of the Center for Inflammation and Regenerative Modeling at the University of Pittsburgh School of Medicine, developed a computer simulation that accurately replicates outcomes and predicts population results contrary to expectations. Their research is published in Science Translational Medicine.

Trauma induces acute inflammation in the body that is crucial for tissue survival, but a sustained inflammatory response can compromise healthy tissues and organs. The research team measured inflammation markers, including interleukin-6 (IL-6), and the model predicted that, on an individual basis, virtual patients who made more IL-6 in response to trauma were less likely to survive. But at the population level, there was little difference in survival between high- and low-IL-6 producers.

The findings indicate that there are limitations to extrapolating outcomes to populations, which is exactly how most treatments are developed. Instead, a dynamic computational model that can simulate multiple factors that interact in complex diseases like trauma may be a better way to predict outcomes. The avenues that look most promising as a result can then be pursued in clinical trials and perhaps lead to greater success.

Read More.

Heroes of Military Medicine Honored at CP3 Banquet

Friday, May 8th, 2015

Dr. Peggy Knudson, NTI Board member and Medical Director for the Military Health System (MHS) Strategic-ACS Partnership, is flanked by Heroes of Military Medicine Bob Woodruff and Colonel Todd Rasmussen at a Center for Public Private Partnerships (CP3) awards banquet last night.

Colonel Rasmussen was one of three active duty military medical professionals to receive the Hero of Military Medicine Award, while Woodruff and his wife, Lee, received Hero of Military Medicine Ambassador Awards. Woodruff suffered a traumatic brain injury from a roadside bomb in Iraq in 2006, while reporting for ABC “World News Tonight.” After his recovery, he and his wife founded the Bob Woodruff Foundation in support of veterans and their families.

Each year, CP3 honors individuals who have distinguished themselves through excellent and selfless dedication to advancing military medicine and enhancing the lives and health of the country’s wounded and ill service members, veterans and their families. Proceeds from the Heroes of Military Medicine dinner support the Veteran Metrics Initiative, which conducts translational metrics-related related research to determine what best improves the health and well-being of veterans.

May is National Trauma Awareness Month

Monday, May 4th, 2015

May is National Trauma Awareness Month. Established by President Ronald Reagan in 1988, National Trauma Awareness Month is a time to recognize the tremendous toll trauma takes on our society.

More than 190,000 Americans die from traumatic injury each year, and trauma costs us more $585 billion in health care and lost productivity. Traumatic injury is the #3 cause of death in the U.S., yet there is no consistent funding mechanism or health institute for its study. NTI advocates for consistent federal funding, a focused research agenda, a trauma clinical trials network and a trauma research repository so the trauma care community can begin to close the gaps in knowledge and save more lives.

Learn more about trauma in America and NTI’s work HERE.