A group of individuals working together toward a common goal in a high-pressure environment – sounds like a sports team, right?
The trauma team at your local hospital in many ways operates like your favorite sports team. However, in these situations, the stakes are actually life and death.
A trauma care team includes physicians, nurses, and other specialists, all of whom have specific roles in the patient care process. Those team members need to execute their roles to achieve the best patient results.
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The Starters: Core Members of a Trauma Critical Care Team
When first responders bring a patient into the emergency department, a team converges to begin the resuscitation and stabilization process. They work together to stop any bleeding, take preliminary scans, start IVs, set up airways, and more.
Attendings: Two attendings – one who oversees the emergency department, and another responsible for trauma – act basically as the co-captains of the process. The trauma attending is a surgeon who manages the patient from the trauma side and is responsible for care in the trauma bay and beyond. The emergency attending is always present in the emergency department and is responsible for all the patients there, trauma or not.
The two attendings work in tandem in trauma cases. If the trauma attending is unavailable when the patient comes in, the emergency attending oversees the case until the trauma attending is available.
Trauma chief resident: Generally a doctor training to be a surgeon, the chief resident in trauma cases helps to oversee the care in the trauma bay.
Residents: Residents are team leaders who help to oversee care and assign actions. In a teaching hospital like UPMC, a trauma resident isn’t necessarily training to become a surgeon. It could be someone from a different specialty doing a trauma rotation. Interns are more junior than residents, but they are also active participants in trauma care. Medical students are usually are only involved as observers, though they may also be involved in patient care under direct supervision from a physician.
Nurses: There are two primary nurses in the emergency department. The charge nurse records everything happening in the resuscitative phase. The primary nurse is responsible for patients: getting them on the monitor, taking the first set of vital signs, making sure IVs are running, getting blood work, and more.
Emergency department technicians: Also known as an advanced patient care technician, people in this role assist with a wide variety of tasks. Technicians are training on how to start IVs, read monitors, draw blood, put in catheters, and more. They take direction from nurses.
X-ray technicians: They work around the trauma team and take initial X-ray scans.
Anesthesiologists: They can come down from the operating room to help with airways and intubation, if needed.
CT technicians: They can quickly scan the patient’s body via a computed tomography (CT) scan to see what injuries there might be, including internal injuries that might not be visible upon exam.
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A Deep Bench: The Breadth of Your Trauma Team
Although trauma care begins in the emergency department, the breadth of the trauma team extends well beyond those walls. Trauma care can begin with paramedics. After the emergency room, the patient could go to the operating room, which consists of more physicians, nurses, technicians, and more.
Surgeons of a variety of specialties, such as orthopaedic surgeons, neurosurgeons, and cardiac surgeons, can get involved in trauma cases. So can physical, occupational, and speech therapists.
“The emergency department is the front door,” says David Bertoty, clinical director of Emergency and Trauma Services at UPMC Presbyterian. “It’s where they initially experience care, but then moving on, there is a vast array of services on the inpatient side that needs to be maintained with 24/7 readiness to be a trauma center.”
A $21 billion health care provider and insurer, Pittsburgh-based UPMC is inventing new models of patient-centered, cost-effective, accountable care. The largest nongovernmental employer in Pennsylvania, UPMC integrates more than 90,000 employees, 40 hospitals, 700 doctors’ offices and outpatient sites, and a 3.8 million-member Insurance Services Division, the largest medical insurer in western Pennsylvania. In the most recent fiscal year, UPMC contributed $1.4 billion in benefits to its communities, including more care to the region’s most vulnerable citizens than any other health care institution, and paid more than $500 million in federal, state, and local taxes. Working in close collaboration with the University of Pittsburgh Schools of the Health Sciences, UPMC shares its clinical, managerial, and technological skills worldwide through its innovation and commercialization arm, UPMC Enterprises, and through UPMC International. U.S. News & World Report consistently ranks UPMC Presbyterian Shadyside on its annual Honor Roll of America’s Best Hospitals and ranks UPMC Children’s Hospital of Pittsburgh on its Honor Roll of America’s Best Children’s Hospitals. For more information, go to UPMC.com.