The team sees an average of eight to 10 gravely injured patients a day — about 3,000 per year. And last month, the team sprang into action when two Worcester firefighters were rushed to the trauma center from a blaze.
(TNS) — Police, firefighters and EMTs are on the front lines trying to save lives throughout the city of Worcester. But on tragic days when those first responders are the people in need of saving, there’s another front line waiting.
That front line is with the team inside UMass Memorial Medical Center’s trauma center, the only Level 1 trauma center in the region. Whether the patient is a firefighter or a civilian, the trauma team has trained to think quick, identifying injuries and rushing patients to the operating room if needed.
The team sees an average of eight to 10 gravely injured patients a day -- about 3,000 per year. And last month, the team’s surgeons, physicians and nurses sprang into action when Worcester Fire Lt. Jason Menard and Firefighter Chris Pace were rushed to the trauma center from a four-alarm blaze on Stockholm Street.
It’s a scenario that’s happened several times in the last few years, as first responders have been injured in Worcester County. Massachusetts State Police Trooper Thomas Clardy, Auburn Police Officer Ronald Tarentino Jr. and Worcester Firefighter Christopher Roy were all treated at the hospital.
In the case of Clardy, the trauma team was also treating David Njuguna, the man convicted of driving negligently and slamming into Clardy’s cruiser, at the same time.
“The response is exactly the same. There is no choosing of the good guy versus the bad guy. In fact, we try very hard not to know, especially if there’s been some violence associated, we try not to know because then that changes your emotions, and it may change your decision making," said trauma surgeon Timothy Emhoff, who is the hospital’s chief of trauma and critical care surgery.
“We don’t take it without the proper seriousness but the homeless [person] who gets hit by a car gets the same level of treatment as the firefighter who just fell out of a building or a policeman who just got shot," Emhoff added. "It’s the same response.”
Among the trauma team is a social worker who can work on crowd control, or something as simple as providing a box of tissues, while surgeons and nurses work on the patient. Crowd control is especially important when a first responder is injured, as groups of fellow officers or firefighters tend to flood the hospital.
“If you get caught up in that, you’re not taking care of the patient," said Lisa McNamara, a nurse practitioner and the hospital’s trauma program manager. "In the case of a firefighter or police, they’re their own family, and if we have several of them at the same time [trauma team social workers] will help with arrangements, how to get them to the funeral or the wake, they will take care of all of that so they’re very important on our team.”
Among the high-profile cases involving civilians sent to the trauma center are the women injured in a recent shooting in New Braintree.
Reading news articles about the patients they’ve treated after the fact is difficult for the trauma team.
“It’s the same team for anybody," Emhoff said during a recent interview inside the center, which had just cleared out following a patient being rushed in. “The aftermath is horrible, but the response is the same.”
When the team gets a page that a patient is incoming, they spring into action. As many as 10 medical professionals can be working on one patient, including the lead trauma surgeon, surgical residents, nurses, an emergency room physician, EMTs, a social worker, case manager and others.
The center’s mortality rate is about 5 percent, Emhoff said. Many of those deaths are for patients who lost vital signs before making it to the center.
“It’s very time and resource exhausting but the outcomes are generally good if you can get there quick enough," Emhoff said. “We say, anybody who comes in with a pulse, we should be able to save them."
Blood is available within two minutes of a patient’s arrival, Emhoff said. An operating room in always available for the team. Three telephones inside the center provide immediate access to the operating room, blood bank and CT scan.
Of patients who arrive at the hospital still with vital signs but ultimately do not survive, many have head injuries.
“The brain is not something we are very good at replacing. We can replace the liver, we can replace the kidneys, we can replace hearts and lungs but we cannot replace the brain," Emhoff said.
As a general surgeon, Emhoff and his team take on many roles once a patient is out of an ambulance and into the center.
“Immediately, when we see a patient, we’ve got to be the neurosurgeon, the orthopedic surgeon, the urologic surgeon, the plastic surgeon," Emhoff said. “We do everything initially to save life and limb.”
The center serves an area of about 2 million people, including all of Central Massachusetts and stretching into southern Vermont and New Hampshire and northern Connecticut and Rhode Island. Thirteen hospitals in the region will send patients to UMass Memorial if the patient needs specialized trauma care, Emhoff said.
Boston has six Level 1 trauma centers and injured patients are sent across the city, like during the 2013 Boston Marathon bombing. If a mass casualty incident were to happen in Central Massachusetts, patients would be directed to UMass Memorial.
Of the trauma center’s 3,000 patients per year, about 250 or 300 are shooting or stabbing victims, Emhoff said. The center could see zero traumas one day and 20 the next. The center is usually busiest, on average, during summer, on Fridays, Saturdays and Sundays, and from 3 p.m. to 11 p.m.
The trauma team will continue to see patients after they initially arrive at the hospital, seeing them through care in the emergency room, ICU, on an inpatient floor or an outpatient clinic.
Care from the team extends beyond the hospital, too. An injury prevention coordinator helps to organize community events like a teen driving program, gun buyback program and Stop the Bleed, a program by the American College of Surgeons that teaches people how to stop bleeding by applying direct pressure, packing a wound, and using a tourniquet.
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