Florida Trauma Center Marks 20th Anniversary

Delray Medical Center's Trauma Awareness Day highlights the importance of having a trauma center nearby


CYNTHIA ROLDAN, Palm Beach Post | | Friday, May 27, 2011

It's 4 p.m. on Monday, and the trauma unit at Delray Medical Center is quiet.

Statistically speaking, Mondays are the unit's busiest days.

About 4:40 p.m., the waiting ends. The speakers blare: A trauma patient is headed to the hospital by ground.

ETA: 10 minutes.

Two trauma nurses, a trauma surgeon and specialists swarm the room as they prepare for the patient -- a 26-year-old man involved in a motorcycle accident -- to arrive.

It's a Priority 2 call because he has a broken femur, an injury that can result in the loss of a liter and a half of blood, said Tyler Adams, one of two trauma nurses on the clock.

As Palm Beach County Health Care District officials mark the 20th anniversary of its trauma system this month, nurses and doctors say patients like this accident victim are lucky to live in a county where two of the state's 22 trauma centers are located.

"You just don't have a trauma center in every corner," said Margaret Crawford, director of the trauma center at Delray Medical. "It speaks to the commitment of the county's leaders ... those 20-plus years ago."

Trauma system started in 1991

To be sure, most South Florida counties have a fair share of trauma centers. But most counties in the state -- Martin, Indian River, Okeechobee, for example -- don't have any at all.

Delray Medical Center's Trauma Awareness Day on Wednesday sought to point out the significance of that difference: Before the trauma system was established at Delray Medical and St. Mary's Medical Center in West Palm Beach, 33 percent of patients who suffered traumatic injuries died.

(Patients injured north of Southern Boulevard are taken to St. Mary's, while those injured south of Southern are taken to Delray Medical.)

The health care district's trauma system came on line in 1991, after its board approved the purchase of the first Trauma Hawk helicopter ambulance. The first trauma patients received care in May 1991.

Twenty years later, the taxpayer-funded system has treated more than 50,000 patients and reduced the number of patients who die to "less than one percent," according to Dr. Ivan Puente, medical director of the trauma center at Delray Medical.

The system now has two Trauma Hawk helicopters, one of which helped save the life of 30-year-old Michael Briggs in December 2007.

On Wednesday, the West Palm Beach man, shared how he was performing a "complete handstand" on his motorcycle for an acquaintance, without a helmet and with a few drinks in his system, when he lost control and slipped at 25-30 mph.

A woman who saw Biggs fall called 911. He was flown to Delray Medical where doctors found that he had nearly 40 pounds of pressure in his head because of the bleeding and swelling. He was in a coma for 10 days. He walked out of the hospital on Jan. 15 -- exactly one month later.

"Hats off to you," Biggs said to a crowd full of first responders, nurses and doctors. "Without ya'll, we have nothing. We don't have a future."

Delray improves level of care

That future may be brighter for patients taken to Delray Medical. The hospital has, as of May 2, met the requirements to become a provisional Level I trauma center.

That means, in addition to providing the required staff and equipment needed for immediate or follow-up treatment of severely injured patients, 24 hours a day, seven days a week, Delray Medical also meets the provisional requirements of pediatric trauma referral-center standards, established by the Florida Department of Health. St. Mary's also is working on receiving the Level I designation.

Bottom line, officials said, is that more staffers will be readily available for Palm Beach County patients like the 26-year-old motorcyclist, who had almost nine people attending to his injuries at any given time Monday afternoon.

When the man arrived in the unit at 4:52 p.m., trauma surgeon Edgar Rodas took advantage of the fact that the man -- who asked that he not be identified -- was conscious and asked as many questions as he could.

By 4:56 p.m., X-rays were taken as a "primary survey or assessment," to ensure the man had no punctures or major internal bleeding. By 5:01 p.m., it was concluded that his pelvis was not broken.

At 5:09, a CAT scan was done of his brain, neck and torso; since he traveling at nearly 50 mph at the time of the accident and was not wearing a helmet.

Patient kept informed

Trauma nurses Adams, and Emily Palmer talked the motorcyclist through everything they were doing as he described his symptoms and the origin of his pain.

Within minutes, the team knew that nothing major was wrong with his brain. Rodas said the scans would be sent to specialists who can detect the most minute detail.

As of Wednesday, the patient was still at Delray Medical.

He'll likely stay through at least the end of the week, doctors said, because of the type of fracture he suffered.

Though overwhelming at times, he was treated by a staff that works in a "controlled chaos" setting effectively, Rodas said.

"It's like a (NASCAR) pit stop," he said of the trauma process. "Everybody knows what to do, and quickly."

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