Early on a recent Tuesday morning in March, five trauma cases arrived at the Lawnwood Trauma Center in Fort Pierce within mere minutes of one another.
That’s not uncommon.
According to the National Trauma Institute, there is a substantial difference between the care a patient gets in a hospital ER and what they receive at a trauma center.
That’s in no small part because trauma centers are built for speed. The faster trauma cases can be treated, the better the odds of patient survival and recovery. That’s why, according to Kimberly Wright, director of trauma services at Lawnwood’s level two trauma center, “We have a full team of 12 to 16 staff members at the ready.”
“We have one primary trauma surgeon,” Wright continues, “and we have a backup trauma surgeon who usually is covering the ICU as well, and then we have a general surgeon on service who’s usually here during the daytime hours.”
Add to that emergency department physicians, physician’s assistants, emergency registered nurses as well as radiology, laboratory and respiratory therapy staff and you’ve got the team needed to deliver the highest level of trauma care available on the Treasure Coast.
That’s especially important because, as trauma surgeon and medical director Dr. Gary Curcio points out, “It all starts with pre-hospital which is EMS” and Lawnwood deals with no fewer than eight different EMS departments and ambulance services – including Indian River County, Vero Beach, Indian River Shores, St. Lucie County, Martin County, the City of Stewart, the City of Okeechobee and Okeechobee County, as well as Tampa General’s helicopter.
The trauma center’s surgeons, physicians, nurses and other professionals are alerted and briefed on each patient’s precise condition by EMS teams as they attend to the patient throughout the transport process. “Like everything else in the team,” Curcio continues, “you need everybody. If you do your job, the team works. If you don’t do your job, it doesn’t. So we make sure they have what they need and they make sure we have what we need.”
They have to. Last year the Lawnwood center treated more than 2,100 trauma cases and Curcio adds, “our busiest day that I can recall was 21 traumas in one day.”
Then Curcio points out, “The last numbers I’ve seen say we’re actually busier than St. Mary’s,” the level one trauma center down in West Palm Beach.
Perhaps surprisingly, Wright says, “Our highest volume of folks come from ground level falls, believe it or not, so it’s a lot of geriatric patients.” She calls those types falls “kind of a national epidemic,” and quickly adds Lawnwood has a team that goes out to work with seniors in the community on a regular basis in an effort to prevent such falls.
Then Wright goes on to say given the center’s proximity to both the Florida Turnpike and I-95, motor vehicle crashes are “usually our number two” type of trauma case.
After an almost inaudible sigh, Wright then relates that gunshot wounds (GSWs) along with knife wounds, brawls and fistfights rank as the third most common type of trauma treated.
So, how does Lawnwood treat so many and such varied traumatic injuries?
They have protocols.
Or, as Curcio puts it, “The American College of Surgeons comes out with guidelines and they update them every couple of years and they’re very helpful in [establishing protocols for] . . . a lot of what we do. When people come into our trauma center we do what’s called a primary survey. Everybody gets the same examination, every single time, no matter what their injuries are.”
“We go through ABCs. If we’re going down our protocol and the A is not secure – if they can’t breathe – that would be addressed. If B is not secure, that would be addressed. If C is not secure – C would be bleeding and circulation – if that’s not secure, we don’t go beyond that point until that has been addressed and fixed. Many times when we get to C, if it’s serious bleeding, we bypass the rest and go right to the operating room.”
When asked who pays for trauma care, Curcio has a quick answer. It might not thrill hospital administrators but it is succinct and to the point. “My focus is taking care of the patient,” says Curcio. “I don’t care how they pay for it. I don’t care if they pay for it. That’s not my job.”
