Busiest day ever for Shands trauma center

Published: Monday, January 30, 2012 at 9:27 p.m.
Last Modified: Monday, January 30, 2012 at 9:27 p.m.

For the sheer number of trauma patients brought in from a single incident, Sunday represented the busiest day in the eight-year history of the Shands Critical Care Center at the University of Florida as a Level I Trauma Center.

Ten died in the string of car crashes early Sunday on Interstate 75. But all 21 patients who made it to a hospital — 18 at Shands at UF and three at North Florida Regional Medical Center — were still alive 33 hours later Monday afternoon.

That number included six patients who were deemed to have traumatic injuries, the most the trauma center has ever handled at one time, hospital officials said.

A 2006 bus crash that killed seven children in Union County resulted in injuries to 11 others, but just five of them needed the trauma center. A 2010 accident at Camp Blanding hurt 24 soldiers but critically injured just one, who was airlifted to Shands at UF.

“I don’t recall any other incidents that brought quite this toll here,” said Dr. Adrian Tyndall, medical director of the Shands Critical Care Center Emergency Department.

Most patients in this incident suffered injuries from blunt trauma, which can cause head, chest and abdominal injuries as well as broken bones.

One patient needed immediate surgery, hospital officials said.

Tyndall said the hospital activated its emergency command center soon after emergency responders alerted them of potential mass casualties in a wreckage of about 20 different vehicles. The hospital summoned four other trauma surgeons beyond the one its trauma certification requires to be onsite and other medical personnel. At full strength, 30 nurses and 10 doctors were providing care in Sunday’s early morning hours.

It’s exactly what a trauma center is prepared to do, said Tyndall, who described a scene of professional calm through his department in Sunday’s early hours. “It was amazing how smoothly it went,” he said.

He said patients’ arrivals — the most traumatic cases coming in one by one — allowed personnel to give each patient the needed care. Shands has four trauma bays and two resuscitation rooms that can double its capacity in a pinch.

Before the trauma center was certified at the facility on Archer Road in October 2004, the same level of care would have been either 81 miles northeast at Shands at Jacksonville or 114 miles southeast at Orlando Regional Medical Center.

That means the clock could have been ticking well past what emergency and trauma personnel call “The Golden Hour” that follows traumatic injury when medical treatment is most effective at preventing irreversible internal damage.

Tyndall said that’s because too much bleeding can rob the bodily tissues of the oxygen they need to survive. That can bring on a cascade of events in the body’s system that can lead to shock and then death.

Coincidentally, the Department of Health was at Shands at UF on Monday to review its trauma certification. Tyndall said he expects the response to Sunday’s incident to be part of that review.

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