Trauma Systems and Trauma Centers
As a trauma patient or the patient’s family member or friend, you will encounter numerous individuals who will contribute to the trauma patient’s overall care. As a patient, you will most likely first interact with the paramedics at the scene of your injury. However, as a family member or friend, your first interaction is usually with a representative of the hospital, often a social worker or chaplain, who can provide you with basic, general information about your loved ones care and can support you through this difficult time. In the trauma bay, numerous staff stands ready awaiting the patient’s arrival. The brief list includes trauma surgeons, emergency medicine physicians and their residents, nurses, respiratory therapists, x-ray technicians,emergency room nurses and operating room staff, including anesthesia personnel. We can assure you; there will be too many people to remember! Their aim, however, is to have all of the resources they could possibly need at your bedside. Nurses will be drawing blood and starting IVs; residents or physicians will be asking several but specific questions and performing their physical exam. Often, multiple x-rays will be taken.
The goal of the team in the trauma bay is to determine all of the injuries the patient has suffered and what is the next best step to address those injuries. Some patients will be taken to the Radiology department for a CT scan; for others, it is directly to the operating room; some will be taken to the Intensive Care Unit (ICU) for close observation, IV fluids, blood, and further testing. For family members and friends, time seems like an eternity. Social workers or chaplains are there to explain in general terms what is going on behind the scenes and to provide emotional and spiritual support; however, they may not have specific information about how your loved one is doing. At that moment in time, the patient is best served by having the doctor’s full attention. After the patient is stable, meaning that his or her vital signs are within the normal limits, and after the initial evaluation and studies are complete, the physician will provide family members and friends with an update on the patient’s condition.
Depending upon the patient’s hospital course, he or she may be transferred to the general surgical floor, to the operating room, or to the Intensive Care Unit. In the Intensive Care Unit, nurses are typically assigned to one or two patients due to their complex needs. It is common to see respiratory therapists as many patients require ventilator support to breath. Often, multiple physicians are involved in a patient’s care. On the general floor, trauma patients will work more heavily with the physical therapists and occupational therapists as they continue to heal and recover. A smaller number of physicians focus on providing the patient’s medical care. Social workers become essential in ensuring that proper care and centers for recovery after the hospital are secured. Whether in the ICU or on the floor, multiple individuals will be asking you questions and visiting throughout the day, it is at times impossible to remember them all. Do not hesitate to ask them who they are and what their job is and if need be, write the information down. Trauma is a complex injury that requires detail-oriented care; involving individuals with multiple areas of specialty ensures that the patient can be on the road to recovery.