Why Do We need a Trauma Center in North Central Florida?

Published: Friday, January 7, 2005 at 1:40 p.m.
Last Modified: Friday, January 7, 2005 at 1:40 p.m.

It is a fact that trauma centers and trauma systems save lives. Numerous peer-reviewed studies have documented this fact over the last 25 years. Florida is considered to be one of only five states in the United States with a mature trauma system, which is defined by eight very specific criteria including a site survey process, a quality assurance process and other measures. All mature trauma systems start with a state designated office of trauma regulated by state statute and state law. We are fortunate in Florida to have such a system.

There are approximately 239 acute care hospitals in Florida and only 21 trauma centers. These unique centers possess the physical plant, the medical staff, the nursing staff, and the ancillary staff to care for our most severely injured patients at the highest level of care. In Florida, we have Level I, Level II, and Pediatric Trauma Centers. All seven Level I centers are, by definition, Pediatric Trauma Centers. A pediatric patient is defined by the state as under the age of 16, thus all patients 16 years of age and older are adult trauma patients.

Shands at the University of Florida in Gainesville is an ideal venue for our newest Level I Trauma Center. We have an outstanding administrative commitment from Shands Healthcare CEO, Tim Goldfarb. He was previously in Oregon working with Dr. Donald Trunkey, considered by many to be the father of trauma in the United States. We have a newly organized Department of Surgery, headed by Dr. William Cance, who upon his arrival as the new chairman of the department created a Trauma Service within the department. Dr. David Mozingo, the chief of the Division of Trauma, Burns, and Emergency Surgery heads our state-of-the art Burn Unit, which is the busiest in the state with more than 300 burn patients treated last year. Finally, we have an outstanding critical care medicine division headed by Dr. Joseph Layon, an outstanding emergency medicine division headed by Dr. David Seaberg, and many other outstanding support departments to make Shands at UF a world-class trauma center.

The need for a trauma center to serve North Central Florida has now been realized. We serve all eleven counties within our trauma agency and parts of three other counties that are half the distance between our center and the three other Level I centers surrounding us - Shands Jacksonville, Orlando Regional Medical Center, and Tampa General Hospital. The trauma center is accessible to all patients in our service area either by the outstanding air rescue services or ground EMS services within the service area.

The goal of the Shands at UF Trauma Center is to impact the most severely injured population in our service area. These patients are technically referred to as Trauma Alert patients, based on state guidelines. There are absolute physiologic criteria such as Glasgow Coma Score less than 12, systolic blood pressure less than 90 and others. There are absolute mechanism-of-injury criteria such as penetrating injuries to the head, neck, or torso or burns greater than 15% body surface area. And there is also a mechanism for a paramedic, in his or her judgment, to identify a patient as a trauma alert.

However, what is all this about? It is about not missing a single injury that could lead to a preventable death. It is about providing a trauma surgeon and a specialty trained emergency room physician to MEET the trauma patient at the door of the emergency room upon arrival, 24 hours a day - every day, and treating lethal bleeding from the chest, abdomen, or extremities before a patient goes into irreversible shock and dies. It is about providing airway assistance and oxygen to the traumatic brain injured patient to prevent the secondary zone of injury and improve neurologic outcome.

These are the services that Shands at UF can provide that no other institution can provide in North Central Florida. I am proud of the commitment that the hospital administration, the College of Medicine and my colleagues have made to this effort and it is truly a pleasure to be a part of this exciting endeavor.


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