Catastrophic Car Crash? Nicked Aorta? You’ll Want To End Up Here

It flashes across the news day after day. Gunshot wound victim taken to Methodist Hospital, a Level I trauma center. Car crash victim rushed to Methodist, Level I trauma center.

Critically injured patients who are treated at Level 1 trauma centers have a 25 percent increased chance of survival. They recover more quickly. They have fewer lasting side effects from their injuries.

But why? What does it mean to be a Level I trauma center? We sat down with Jill Castor, trauma program manager at IU Health Methodist Hospital, to break it down.

In-House Round The Clock

Trauma centers are ranked by the American College of Surgeons. To be a Level I center means a hospital offers the most comprehensive and highest level of surgical care for the critically injured. Standards are set by the college of surgeons.

“Where you perform in that is up to you,” Castor says. “We aim up here, at the highest level.”

Being a Level I center means in-house, 24-hour resources. A certain number of surgeons, emergency physicians, nurses and anesthesiologists must be on duty around the clock.

Methodist hospital is home to the largest number of acute care surgeons in the state, and it is a 24 hour operation.  Every day and night, two board certified surgeons are in house and able to respond within 15 minutes to a traumatically injured patient.  It doesn’t matter whether it is 2 o’clock in the morning or 2 o’clock in the afternoon, they are always prepared.

Minutes Matter

When a trauma patient arrives at Methodist, a full team must respond in 15 minutes or less.  A team that includes a trauma surgeon, a chief resident, a nurse practitioner, a second-year resident, two bedside nurses, a chaplain, a forensic nurse, a social worker, a radiologist, a pharmacist.

“As soon as you come to our hospital, all those people come to your bedside,” Castor says. “They are all there as soon as you get here. We have to be there in less than 15 minutes and usually we’re there beforehand.”

Carving Niches

Methodist has the most specialties of any Level 1 trauma center in the state. It is an academic healthcare system, so it has residents, produces research and is innovative.

Among a key specialty for Methodist is the Extracorporeal Membrane Oxygenation program for trauma. If a patient’s heart or lungs need bypassed, Methodist will use ECMO to do that. The hospital’s microvascular capabilities and cardiovascular surgery are also specialties.

“So, if you nick your aorta, you’re going to come here,” Castor says. “We are going to fix that.”

Methodist is the only hospital in the state that can.

Not The ER

Many people think that the trauma team or center is synonymous with the emergency department, Castor says. It is not. The trauma team is a service line, much like neurosurgery or orthopedics.  

“A lot of people think we’re housed in the emergency department, but we are across the continuum. We span across all departments,” Castor says. “So, from the time you get hurt until the time you get back home, that’s all within our scope.”

Methodist’s Level I Offerings:

  • A dedicated trauma surgeon on duty in the center 24 hours a day
  • Neurosurgical and orthopedic surgeons attending in-house 24 hours a day
  • Critical care attending in-house 24 hours a day
  • A full spectrum of surgical specialists --orthopedicneurosurgerycardiovascular, thoracic, hand, microvascular, plasticobstetric and gynecologicophthalmologyotolaryngology and urology -- on call 24 hours a day
  • A surgical director with added certification in surgical critical care from the American Board of Surgery and expertise in perioperative and post-injury care of injured patients
  • A complete staff of medical specialists in cardiologyinfectious diseasepulmonary medicine and nephrology, along with their respective support teams, such as respiratory therapists and dialysis team
  • A respiratory therapist available to care for trauma patients 24 hours a day
  • In-house radiographer and CT technologist
  • Physical and occupational therapists and rehabilitation specialists
  • Acute care nurse practitioners
  • Trauma/critical care pharmacy

-- By Dana Benbow, Senior Journalist at IU Health.

   Reach Benbow via email dbenbow@iuhealth.org or on Twitter @danabenbow


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