Trauma Program
Children's Hospital of Wisconsin is certified as a Level I pediatric trauma center, able to provide the best possible care to the most critically injured children. The American College of Surgeons grants Level I certification to hospitals that provide not only the highest quality of care to their patients, but are actively involved in injury prevention activities, continued research and education.
Many specialists and hospital departments are needed to support this level of care. These include the trauma team and the trauma service. The trauma team (see below) is made up of nearly 20 different pediatric experts who are available 24 hours a day, seven days a week to respond to the Emergency Department/Trauma Center (ED/TC) to care for the child's immediate crisis. About 200 trauma stats are called each year at Children's Hospital. Many of these children are injured by motor vehicle crashes, bicycle crashes, snow boarding/sledding crashes, falls, house fires and other causes of burns, violence, poisons and drowning.
After initial treatment in the ED/TC, most trauma patients are admitted to the hospital and require surgery, rehabilitation and long-term follow-up care. The trauma service (see below) is the group of pediatric experts that sees the children through this stage of their recovery.
Trauma team
When a trauma stat is called at Children's Hospital of Wisconsin, as many as 15 pediatric specialists from different areas of the hospital respond to the Emergency Department/Trauma Center (ED/TC) to care for the child. Each specialist has a specific role. Their titles and roles are:
Transport team (made up of a nurse, respiratory therapist and sometimes a physician) often is the first Children's Hospital staff to see the patient at the accident scene or another hospital where they stabilize the child and transport him or her to Children's Hospital. They also work in the trauma room helping the emergency department and critical care nurses.
Emergency department nurses prepare the trauma room for the child's arrival, assist the physicians and care for the patient. An emergency department nurse also serves as the official recorder, documenting all data, such as vital signs, procedures, assessments, lab draws and medications.
Emergency department physician is the initial person coordinating the trauma and resuscitation. For the highest level of trauma, a pediatric surgeon takes over directing the trauma and the emergency physician works with the surgeon.
Pediatric surgeon assesses the patient's need for surgery and performs procedures in the trauma room if necessary. He or she directs the care of the patient in the highest levels of trauma.
Critical care nurse provides general support and helps the physicians and other nurses care for the patient.
Critical care physician provides direct patient care as well as consultation during Trauma Stat resuscitations and assists in procedures, if required.
Anesthesiologist provides an airway for the patient, advanced resuscitation and neurologic assessment and treatment. If surgery is required, the anesthesiologist puts the child to sleep, maintains patient safety and comfort, and performs ongoing resuscitation.
Laboratory technician and the Southeastern Wisconsin Blood Center make sure there is sufficient blood and blood products (platelets, fresh/frozen plasma) available for the patient. The technician also collects and performs tests on the lab specimens to help clinicians diagnose the trauma patient.
Radiology technologist provides general diagnostic and CT scan services 24 hours a day, seven days a week. Radiologists are available at all times, either in-house or on call.
Respiratory care practitioner helps the anesthesiologist keep the patient breathing, helps keep the patient's spine immobilized and helps transport the patient for testing and to the Pediatric Intensive Care Unit. Stationed at the head of the bed, the respiratory therapist often tries to talk to the patient to let him or her know what is happening and what treatments are being done.
Operating room nurse attends the trauma to find out if the child will need surgery, and if so, when and what kind so preparations can be made. If a procedure needs to be done in the trauma room, the operating room nurse assists.
Pharmacist anticipates the medication needs of the patient and prepares them as required. The pharmacist also provides key drug information, such as drug interactions and appropriate doses, and offers input on what drugs will be given.
Social worker gathers medical and social information on the child and provides this to the medical team. He or she also updates the family on their child and calls in support services the family may need, such as Spiritual Care or Child Life.
Security officer secures the trauma room and assists the police department if involved.
Trauma Service
A trauma patient's care usually goes beyond a trauma stat and often includes a hospital stay, surgery, rehabilitation and long-term follow-up care. The following specialists are part of the trauma service and see the patient through the rest of their recovery:
Advanced practice nurse (APN) is a nurse with additional education and training who serves as a case manager for inpatient trauma victims and makes sure proper discharge planning and family education is done.
Inpatient nurses care for the child's day-to-day needs, following the plan of care set by the family, APN and surgeon.
Pediatric surgeon directs the overall care of the trauma child.
Critical care physician directs the day-to-day care of the child in the intensive care unit.
Case management staff work with the advanced practice nurse to plan for all discharge needs, including equipment and supplies. A case manager may work with families at home to help them coordinate multiple health care appointments and lengthy or difficult treatment plans until home care becomes less complicated.
Rehabilitation staff, including physical and occupational therapists begin exercises and sessions with children while they are inpatients. PT/OT usually continues on an outpatient basis long after the child has been discharged from the hospital.
Child life specialists help families adjust to the hospital. They encourage and play with children and prepare them for procedures by letting them see and touch instruments that will be used and explaining what the child will see, feel and hear. Child life specialists also are available to support parents and help explain the hospital and illness to siblings.
Pain management physicians and nurses offer a variety of treatments to keep children as comfortable as possible while in the hospital and at home.
Dietitians work with the child and family on good nutrition and make sure the child is eating enough food to get better.
Surgery clinic staff care for the child long-term in the outpatient clinic.
Injury prevention
While specialists that make up the trauma team and trauma service care for children after they are injured, an essential part of the trauma center is injury prevention.
Through Project Ujima, Children's Hospital helps prevent the cycle of violence by reducing the numbers of repeat victims of violence.
Trauma center staff work closely with staff at the Children's Health Education Center, (CHEC) a member of Children's Hospital and Health System. CHEC provides programs and resources in health education including field trips, outreach programs, babysitter training, youth leadership development, safety and injury prevention events and asthma education. Parenting Works is published by Children's Hospital and Children's Health Education Center to promote healthy parenting. CHEC also is the lead agency of the Safe Kids Southeast Wisconsin Coalition.
Research and Education
Children's Hospital keeps a trauma registry with information about injuries and trends, which provides important data for hospital staff doing research. The registry often is used to provide data that supports injury prevention programs.
Children's Hospital offers ongoing lectures and conferences for staff and other health care professionals on a variety of trauma-related topics. |
