Trauma Takes Team Approach

When you're injured in an accident, an emergency room doctor is the first line of defense to save your life. But it takes a whole team to put you back together.

Thirty-two-year-old Nici Taylor found that out firsthand. The Emporia police dispatcher is reminded every day how important it is to wear a seatbelt, especially the night in January when she took hers off.

Heading home on the Turnpike, she took off her seatbelt to sleep. The driver then fell asleep at the wheel. The truck rolled and Nici was thrown out. She says she woke up to people looking around for her in the dark.

Nici was flown to Stormont-Vail, where the Trauma Team sprang into action. She said it seemded like 15 people hovered around her at once.

But that was just the first line of defense. Once that group stabilized Nici's collapsed lungs, a second wave was called in.

Dr. Joseph Mumford of Kansas Orthopedics and Sports Medicine was Nici's orthopedic surgeon. He says he remembers well the patient that had two broken arms, a broken ankle and a spinal fracture.

Dr. Mumford and his colleagues are an integral part of Stormont's Trauma Team. An estimated half of all trauma patients nationwide have an orthopaedic injury. Dr. Mumford says the difference with Stormont's Trauma Team is that those patients are more accurately stabilized and assessed before getting to him. He says patients wouldn't want ortho managing their airway or taking care of their head trauma. With the team, Dr. Mumford says, the specialists then are called in at the best possible time. He says it means better results and fewer complications by addressing the problems early.

Nici has a plate and screw in one arm and a rod is holding the other together while the bones heal. She's confident the team approach is what helped her. She says it made the difference between being able to use her arms and not.

The experience also drove home a lesson she's all too willing to share.

"Never take off your seatbelt," she said. "I would never make that mistake again."

Stormont-Vail started its trauma service a year and a half ago. Its directors say support from not just surgeons, but all areas of health care, is why it's been so successful.

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The following is from the Orthopaedic Trauma Association,

Orthopaedic Trauma Service Organization
More than half of patients admitted to most trauma centers have musculoskeletal injuries. Providing optimal care for these patients is an essential task for all trauma centers and trauma systems.

In North America, the definitive musculoskeletal care provider is an orthopaedic surgeon. Training in this specialty provides the necessary knowledge and skills for treating patients with fractures, dislocations, and injuries of ligaments, muscles, tendons, and cartilage.

All orthopaedic surgeons are not equally prepared to care for patients with serious injuries. Subspecialization within orthopaedics has led to significant advances in treatment of musculoskeletal conditions of all kinds, but with the inevitable result that distribution of expertise and skills is not uniform. The care of serious injuries, and of severely injured patients with (frequently multiple) musculoskeletal injuries has become an orthopaedic subspecialty area. While orthopaedic surgery residency training and board certification offer a general level of knowledge about the evaluation and treatment of skeletal trauma, they do not provide the orthopaedic generalist, or subspecialist in another field, with all the skills required for care of the seriously injured.

Fellowship training in orthopaedic traumatology is one way an orthopaedic surgeon can prepare for a career that focuses on definitive care of serious injuries. The necessary skills can also be obtained through residency training, self-study, collaboration with others who are practicing in the field, and appropriately chosen continuing medical education programs. All of these, in addition to frequent practice through direct care of seriously injured patients, are required for the surgeon to maintain his/her orthopaedic trauma skills. Most important is the orthopaedic surgeon's commitment to the care of injured patients, which means that he / she must demonstrate willingness to interrupt other activities, often at inconvenient times. This inevitably interferes with elective care of other patients, and with personal pursuits.

The goal of a well-organized trauma system is to ensure that each injured patient is promptly and safely delivered to a hospital that provides optimal, timely care for all injuries. This care does not conclude until the process of rehabilitation has been completed.

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