Path of a Trauma Patient - Eskenazi Health

The Smith Level I Shock Trauma Center at Eskenazi Health provides the most extensive range and quality of trauma care in Indiana, serving as the first adult Level I trauma center in the state. Eskenazi Health has five state-of-the-art shock trauma rooms, and is staffed by specially-trained surgeons, anesthesiologists and certified emergency nurses (CENs). Together, with emergency medicine faculty and staff, and an outstanding group of specialty care providers, the Smith Level I Shock Trauma team delivers expert care to each and every trauma patient at Eskenazi Health. Please join us as we take you on the Path of a Trauma Patient:

When a patient is brought to the Smith Level I Shock Trauma Center at Eskenazi Health via ambulance or helicopter their vitals have been taken during the transport from the injury site to the trauma center. The administration of medications and/or procedures have been conducted to stabilize the patient. The shock room staff is notified of the incoming patient and their condition through a trauma alert and they begin to prepare for the patient’s arrival.

Once the patient arrives, they are taken to one of our five shock trauma rooms by the paramedic-led team. This team hands off the care of the patient to a specially trained team of trauma and emergency medicine physicians, nurses, pharmacists and respiratory therapists. The patient is then transferred from the emergency medical transport cot to the shock room bed for assessment and further care.

While a patient is in a shock trauma room, also referred to as a resuscitation room, the trauma team continues to monitor the patient’s airway, breathing, circulation and disability until the patient condition is stabilized, the diagnosis is complete, and all resuscitative procedures and surgeries are complete. This involves monitoring patient vital signs, protecting the airway with assisted ventilation and oxygenation as needed, and providing the necessary IV fluids and blood products. All injuries of a patient are identified through a thorough head-to-toe examination, and the patient’s vital signs are reviewed again, along with their medical history.

The anteroposterior (AP) chest radiograph is the most common imaging study performed on trauma patients at the Smith Level I Shock Trauma Center at Eskenazi Health. These images can be obtained during the resuscitation phase while the patient is in the shock trauma room. Radiographic imaging provides vital diagnostic data that aids in the initial evaluation and in the placement of chest and endotracheal tubes, which are critical to the resuscitation effort and the primary survey.

Once a patient is stabilized, they are often taken for further testing. The trauma surgeon may order a CT scan of the head, neck, chest, abdomen and pelvis to assist in locating internal injuries or bleeding.

Eskenazi Health has an industry-leading, state-of-the-art CT scanner. Our scanners allow trauma surgeons to locate injuries with unprecedented accuracy and speed. A scan can be acquired from head to toe in less than 30 seconds. Speed and accuracy are critical factors in the care of the trauma patient.

Patients that have sustained injuries from trauma often need lifesaving surgery. There is a dedicated operating room (OR) and team available 24/7 at Eskenazi Health for trauma patients. This OR suite is available in a moment’s notice to receive trauma patients. The OR is staffed with a specially-trained team of nurses and certified surgical technologists that work alongside anesthesiologists, trauma surgeons, orthopaedic surgeons and neurosurgeons to treat a patient’s injuries. A call is made to the OR and the trauma team responds instantaneously by preparing the trauma room for the patient. The patient is rushed into the OR and moved to the operating table. Simultaneously, anesthesia puts the patient to sleep, and the patient is prepped and draped, and the initial incision is made.

After a trauma patient undergoes surgery in the trauma operating room, they are often transferred to the post-anesthesia care unit (PACU). This unit is designed to provide care for patients recovering from anesthesia. The Eskenazi Health PACU staff consists of anesthesiologists, certified PACU nurses and surgeons. This highly-trained team is responsible for monitoring vital signs, airway management and oxygen administration for patients who have undergone a general anesthetic, managing the patient’s post-operative pain, treating symptoms of post-operative nausea, thermoregulation, and monitoring surgical sites for excessive bleeding.

A trauma patient may also be transferred to the Surgical Intensive Care Unit (SICU) at the Sidney & Lois Eskenazi Hospital where resuscitation continues. The patient is continuously monitored by a specially-trained team of board certified critical care surgeons, anesthesiologists, nurses, surgical residents, respiratory therapists, registered dietitians, and physical, occupational and speech therapists. Members of the SICU team are highly skilled in ensuring that the acutely and complex, critically ill patient and their families receive optimal care.

During recovery, a case manager is assigned to each patient. Case managers assist patients and their families in coping with the stress of hospitalization by acting as the patient’s advocate, providing resources, education, support and guidance during and after their stay at the Sidney & Lois Eskenazi Hospital.

Rehabilitation is a crucial component to the overall recovery of trauma patients. During recovery, the patient is assigned a team of rehabilitation service professionals, including physical therapists, occupational therapists and speech therapists. These professionals work directly with the patient to assist them in being able to perform day-to-day functions. Physical therapists help patients reduce pain and improve or restore mobility through a variety of treatment techniques and strength-building exercises, while occupational therapists work with the patient to improve independent functions of daily living such as getting dressed or eating. Speech therapists play an important role with the treatment of speech and language, swallowing and communication after intubation. Trauma patients may continue to participate in rehabilitative activities well after being discharged from the hospital.

For more information about the Smith Level I Shock Trauma Center, please visit http://bit.ly/1Qj07Tf. To refer a trauma, orthopaedic trauma or burn patient, please call 1.800.4.TRAUMA.