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New Procedures Improve Chances for Trauma Victims

New ER Procedures Improve Survival Chances for Trauma Victimsi
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April 22, 2013 1:39 PM
As cases of gun violence fuel the debate over tougher gun laws across the United States, there is one statistic that is positive. Hospitals in many states are seeing fewer gunshot injuries according to doctors at one California trauma center. And for those who suffer from these injuries or other severe trauma, doctors are improving their chances of survival. Elizabeth Lee has the details from Los Angeles County-University of Southern California Medical Center.
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Elizabeth Lee
— As cases of gun violence fuel the debate over tougher gun laws across the United States, there is one statistic that is positive. Hospitals in many states are seeing fewer gunshot injuries according to doctors at one California trauma center. And for those who suffer from these injuries or other severe trauma, doctors are improving their chances of survival.

At one of the largest trauma centers in the United States, a multi-disciplinary team of doctors and nurses works quickly to save the life of a 60-year-old man suffering from multiple stab wounds. Dr. Peep Talving is the trauma surgeon on call.

“When he was closing his shop there was a robbery, and they stabbed him. He got six stab wounds to the chest, one to the abdomen and two to the neck,” said Talving.

Methodical processes

Dr. Demetrios Demetriades, director of Trauma Services at the Los Angeles County - University of Southern California Trauma Center, said when someone is severely hurt, members of the trauma team are activated.

"Everybody in our center is expected to be in the emergency room within five minutes of activation. This means that they are there before the patient arrives. And each person has a dedicated duty," he said.

Demetriades said this methodical way of treating patients at a trauma center has lowered the preventable trauma deaths to less than two percent.

Other advancements also have improved survival rates. One of them is a change from having paramedics stabilize the patient at the scene to what is called “scoop and run.”

“Don’t waste any valuable time trying to stabilize the patient. Put him in the ambulance and take him to the hospital to the trauma center immediately without any delay,” said Demetriades.

Different treatments

Talving said that is especially critical with gunshot and stab wounds. “Particularly with the penetrating trauma because if you got a vascular injury to the chest torso, there is nothing else than surgery that will stop the bleeding.”  

That is the case for the elderly stabbing victim. Talving had to operate to stop the internal bleeding. The concept of “scoop and run” also is one of the reasons why 18-year-old Juan Gallardo survived a drive-by shooting. Demetriades described the injuries.

“This patient has a gunshot injury to the heart and lung. Twenty years ago he would have been dead and buried - had memorial services every year,” he said.

After surgery, though, Gallardo is returning home two weeks after the shooting. “I’m planning on going back to school and go to church.”

In another change, the hospital operates selectively on patients with gunshots to the abdomen - especially if no vital organs are hit. Not operating reduces medical complications after surgery.

Additionally, in a lesson learned from the war zones of Iraq and Afghanistan, Demetriades said there's a new procedure instead of the traditional method of giving trauma patients large amounts of intravenous fluids such as saline.

“Now we give blood products. We restrict all types of fluids. We give fresh blood products and again this has made a very significant difference,” he said.

Changes like these have improved a patient's chances of survival in trauma centers by as much as 25%. As for the elderly man who was stabbed, he is expected to make a full recovery.

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