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Ready to care for severely injured patients

How Mary Washington Hospital's new trauma service worked for one accident victim

Date published: 9/19/2008

BY JIM HALL

Mary Washington Hospital became a Level II trauma center this week.

But the state designation simply makes official a type of care that has quietly been offered at the Fredericksburg hospital for several months.

Hospital officials were hesitant to publicize that fact, for fear that they would seem presumptuous during the Virginia Department of Health's permitting process.

But the first trauma surgeon arrived at the hospital about a year ago, and three others arrived this spring and summer. Since then, Mary Washington has been a trauma center in all but name.

One example of what this means for patients can be found in the aftermath of a three-vehicle auto accident that happened in Spotsylvania County on Sept. 3.

Tami May's mother was injured in that crash. May's mother is a resident of Fredericksburg and in her 60s. She has a history of medical problems, including problems with her breathing. May asked that her mother's name not be used since she is still in the intensive-care unit.

"She had some pretty intense injuries," May said.

But May said she wanted to talk publicly about what happened to her mother at the hospital and what that might mean for others in the community.

"My past experience with Mary Washington has not been the most stellar," May said this week. "I was a little concerned about how she would be handled."

But May said that the staff there has kept her informed at each step in her mother's treatment, and that her confidence in them has grown.

"These people in the trauma unit, the ER doctor, everybody who's worked with my mom, has been phenomenal," May said.

May said her mother was a passenger in the front seat of a vehicle that crashed on U.S. 1 at Cosner's Corner. She suffered a ruptured spleen, a broken arm, broken ribs and a punctured lung.

May said her mother was taken by ambulance to the emergency department, where Dr. Joel Goodwin, one of the hospital's new trauma surgeons, met her and has helped coordinate her care.

May said that an imaging scan revealed that her mother was bleeding internally, so she was taken to the interventional radiology department.

There a doctor inserted a catheter into one of her arteries and guided it to her spleen.

The doctor embolized the wound by placing small coils there to stop the bleeding.

May said her mother went from the radiology section to the intensive-care unit, where she remains. Goodwin, the trauma doctor, has continued to help care for her, she said.

May said that having trauma care in Fredericksburg made a difference for her mother, since her family could be close to her the entire time.

"If she had to be transported someplace else, her anxiety would have increased, which would have made her breathing more labored," she added.

May said she hopes that her mother will be released from the hospital soon.

"I believe she's on the way to recovery," she said.

Jim Hall: 540/374-5433
Email: jhall@freelancestar.com

WHAT IS TRAUMA? Trauma patients include those who have fallen from a scaffolding or been shot or stabbed. Drowning victims also qualify, as do those who have been strangled or electrocuted. In other words, trauma patients have serious injuries, not the "everyday" kind, said Paul Sharpe, trauma coordinator for the Virginia Department of Health. "A large percentage may be road crashes, maybe bicycle or motorcycle injuries," said Dr. Lawrence Roberts, medical director for the trauma center at Mary Washington. Officials expect their service to care for all of these patients, some 800 a year. The exceptions will be patients with bad burns, those who need a body part reattached and children under 12. They'll go to a Level I trauma center such as Inova Fairfax. --Jim Hall MWH CENTER'S OPENING WAS YEARS IN THE MAKING The opening of its trauma service is a "transformational" moment for Mary Washington Hospital, said Fred Rankin III. Rankin, the president and chief executive officer of MediCorp Health System, the hospital's parent company, compared the new service to the hospital's first open heart surgery or its first brain surgery. All three helped redefine Mary Washington from a small community hospital to a regional, advanced-care medical center, he said. "We have been on this journey for a long time," he said. The hospital began planning for a trauma center about nine years ago. During that time, hundreds of millions of dollars were spent in expansions to the emergency department, radiology section, laboratory, intensive-care unit and operating rooms, Rankin said. The changes were made to keep up with community demand but also with the goal of someday opening a trauma center, he said. That day came Sept. 5, when Dr. Karen Renley, state health commissioner, approved the hospital's application. Renley acted one day after a Virginia Department of Health team visited Fredericksburg to inspect the hospital's preparations. Officials learned of her decision this week. The trauma program costs about $2.7 million a year. The state will contribute from $120,000 to $350,000 annually, depending on how busy the service is. --Jim Hall

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Date published: 9/19/2008

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