A drowsy motorist, headed home after the night shift, falls asleep at the wheel. The car veers over the dividing line and into oncoming traffic, colliding head-on with a small truck driven by your husband. The pickup is totaled; your husband is critically injured. The paramedics are on their way.
Within minutes, Emergency Medical Services (EMS) is assessing the damage: broken bones, trouble breathing, abdominal pain, chest bruising and likely internal injuries. They quickly insert a breathing tube and work to stabilize your husband. At the same time, EMS radios Botsford Hospital to activate the trauma team so that they can begin treating him the instant he arrives.
"With the ambulance en route to the hospital, the trauma team is already assembling in the Trauma Resuscitation Unit [TRU]," says Raimundo Pastor, D.O., a general trauma surgeon at Botsford. "We stay in touch by radio with EMS, so we know what care EMS has initiated and how the patient is responding. And, since we already have some description of the injuries, we start anticipating what specialists may need to be involved and make sure they’re on their way. "Trauma patients typically have multiple, complex injuries, so they need care from a multidisciplinary team of experts, "Dr. Pastor says. "We have a full trauma staff that is available 24 hours a day, seven days a week."
"Within Seconds: Assess The Injury
Top-level trauma care is a carefully coordinated system that relies on speed, skill and teamwork to save lives. Botsford is a verified trauma center, meaning we have the equipment and resources to treat the most severely injured patients, giving them the best chance for survival and recovery.
"Quickly and accurately evaluating a patient with multiple injuries is vitally important because the patient’s chance for survival is greatest when he or she receives appropriate care within the first hour after the injury—also called the 'golden hour,'" Dr. Pastor says. "Studies show that critically injured patients tend to have better outcomes in verified trauma centers."
Within Minutes: Stabilize and Start Administering Care
In the TRU, team members check your husband’s airway, breathing and circulation. The radiology technician x-rays the cervical spine, chest and pelvis. The trauma surgeon performs a physical exam. Diagnosis: extensive injuries, including bruising of the chest and lung, bleeding in the abdomen, a lacerated liver, an injured spleen and a fractured thighbone. Your husband needs surgery right away.
"We have to be ready to go into surgery at any time," says David Fertel, D.O., a trauma surgeon and cardiothoracic trauma surgeon at Botsford. "Prioritizing what injury to address first is a delicate balance. I pull on the education and skill of the entire trauma team. It’s a fast-paced decision process that requires using the team’s many years of trauma experience."
Orthopedic surgeons, for example, are important members of the trauma team. They often treat fractures caused by motor vehicle accidents.
"Air bags have shifted injuries from the upper torso to the lower limbs," says Robert Colen, D.O., an orthopedic trauma surgeon at Botsford. "We often see fractures in the thighbone and shinbone, sometimes fractures in the pelvis. All these conditions, and many more, can be treated by Botsford orthopedic surgeons using the latest techniques."
Besides surgeons, the Trauma Services team consists of a dedicated, diverse group of health experts who represent the wide spectrum of care available at Botsford. This includes:
Rehabilitation and Recovery: Next Steps
A strong, organized rehabilitation unit is a cornerstone of every trauma center. Physiatrists, specialists in rehabilitation medicine, and their team help patients regain function and independence through comprehensive inpatient and outpatient programs.
Rehabilitation specialist Eric Kovan, D.O., typically consults with the patient's orthopedic surgeon two or three times a week to ensure that the patient is getting the maximum benefit from his or her care plan. Dr. Kovan also evaluates the patient's need for in-home support. Social workers can help connect the family with community resources, such as home care and support groups.
"Rehabilitation after a traumatic injury doesn't happen overnight; Dr. Kovan says. "It can take months. But, with the carefully coordinated care provided by the trauma team at Botsford, patients have a better chance of returning to life as it was before their accident.
"It's really satisfying to know you’ve helped people during one of the most challenging times in their life."