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AAMC Members Brief Congressional Staffers on Importance of Trauma Care

Web Exclusive
May 9, 2012

In the aftermath of the Boston Marathon bombings, area teaching hospitals responded quickly, treating hundreds of trauma patients in a matter of hours. The coordinated actions of first responders and the several Level I trauma centers in downtown Boston played a key role in the successful treatment of patients that day. In fact, everyone who made it to the hospital survived.

Dr Murdock speaking from a podium

Sandy Murdock, Dr. P.H., of UTMB describing the state-wide impact of losing a trauma center when UTMB closed.

But what happens if there isn’t a Level 1 trauma center readily available during a disaster or in the aftermath of a car accident?

Bill Mileski, M.D., director of the Level I trauma center at The University of Texas Medical Branch at Galveston (UTMB); Sandy Murdock, Dr.P.H., vice president of UTMB; and Mary Devine, emergency management coordinator with the Conference of Boston Teaching Hospitals, recently briefed congressional staffers on the critical role teaching hospitals play in operating the country’s highest level trauma centers at a Capitol Hill presentation sponsored by the AAMC (Association of American Medical Colleges).

In 2010, UTMB’s Level I trauma center treated many of the 170 injured in the nearby British Petroleum (BP) oil platform explosion off the Texas coast. This was fortunate for patients needing special care—the medical center trauma and burn units had been closed for 11 months in 2008 after the storm surge from Hurricane Ike flooded the hospital’s power generators. The time the unit was closed showed just how important Level I trauma centers are for communities.

“That one episode demonstrated in a practical way how little slack we have in our trauma systems,” said Mileski. “We are not as big as other Houston-area hospitals; they see twice as many patients as we do. But they did not have enough slack to absorb our 2,000 patients a year. Their emergency rooms were overflowing 25 percent of the time, which meant 25 percent of hurt people had to go to smaller hospitals to receive care.”

Level I trauma centers have unique capabilities to respond to a wide range of injuries, from large-scale natural and manmade disasters to everyday vehicle accidents. These hospitals are required to have a certain number of specialists and resources on call to be designated as a Level I trauma center. The facilities also must maintain residency programs to prepare future generations of trauma specialists, research programs to continually improve trauma care, and preventive and outreach programs for the community.

Out of the 4,985 hospitals in the United States, only 112 hospitals have adult Level 1 trauma centers. More than 80 percent of these trauma centers are located at AAMC-member institutions that rely on public investment to partially offset the cost of these and other unique services that teaching hospitals offer. These enhanced medical services require substantial expenses, with many teaching hospitals carrying these additional costs at a loss.

“This is a social obligation that we take on as an academic medical center,” said Murdock. “We feel like we are there for the purpose of the greater good of the community we serve.”

Responding to mass traumatic events is often a logistical challenge for larger states. Texas responded to the recent fertilizer plant explosion in West, Texas, by flying victims to trauma centers throughout the state.

In Boston, victims received timely critical care because of the six teaching hospitals located within a two-mile radius of the blast site: Beth Israel Deaconess Medical Center, Brigham and Women’s Hospital, Boston Children’s Hospital, Boston Medical Center, Tufts Medical Center, and Massachusetts General Hospital.

“Within minutes, the trauma centers cleared out their emergency departments, opened up the operating rooms, and said, ‘We are ready. Send us whoever you have,’” said Devine. “The hospitals did a phenomenal job. Many of the hospitals had operating room teams meet the victims as they came in.”

Boston-area teaching hospitals’ coordinated response to the marathon bombings demonstrates the vital need for Level I trauma centers in communities. Moreover, the closure of the trauma center at UTMB is a cautionary example of the disruption caused to an entire region when a trauma center goes offline.

Video: Triumph Over Tragedy

Bill Mileksi speaking

Officials from the University of Texas Medical Branch at Galveston and COBTH discuss the importance of Level I Trauma Centers at major teaching hospitals.


Speakers Describe Academic Medicine’s Vital Role in Trauma Care

The AAMC sponsored the May 7 briefing, the first in a series highlighting the unique programs and services medical schools and teaching hospitals offer and the irreplaceable role these institutions fill in their communities.