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Monroe Carell Jr. Children’s Hospital at Vanderbilt Named State’s Only Stand-alone Pediatric Level 1 Trauma Center

Jun. 29, 2007, 12:39 PM

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On July 2, Monroe Carell Jr. Children’s Hospital at Vanderbilt will begin operating the state’s first pediatric Level 1 Trauma Center at a children’s hospital.

On that date, a trauma program that has been more than a year in the making will begin treating the highest level of trauma injuries in children 24 hours a day, seven days a week.

“Not only is there no other children’s hospital in the state that is a stand-alone pediatric Level 1 Trauma Center, but there are only 15 in the country recognized by the ACS,” says Stephen Morrow, M.D., medical director of the Trauma Program at Children’s Hospital. “It’s a difficult designation to earn.”

Morrow was tapped to lead the developing trauma program last fall, having served as an assistant professor of Surgery at Vanderbilt since 2005. Beth Broering, M.S.N., R.N., formerly trauma coordinator at Vanderbilt University Hospital, was selected as program manager.

Over the next year, the program will also work toward a national designation for trauma centers from the American College of Surgeons (ACS), which could come by next summer. To meet the criteria for being an ACS-designated Level 1 Trauma center, staff had to be increased in Surgical Services at the Children’s Hospital, the Pediatric Critical Care Unit and the Emergency Department, among other places.

“Significant resource allocations were made, but the leadership of the hospital is well aware that having a trauma program specialized for children is very important.

“Children are actually quite different from adults in the way their bodies respond. They can appear to be stable, even talking and responding appropriately until a critical point is reached in the body’s response to trauma, when they can deteriorate suddenly,” Morrow says.

“As a Pediatric Critical Care physician, I know that the “golden hour” is our best chance of saving a child who has suffered a traumatic injury,” says Kevin Churchwell, M.D., interim CEO of Children’s Hospital. “Children are different from adults and having a program that focuses on the very highest level of care possible in this crucial time period is essential. This is an important step toward providing the highest level of care possible for children in Middle Tennessee and beyond.”

Previously, the trauma service at Children’s might have been considered a level two or three by state standards because severely injured, unstable children were sent to the adult Level 1 Trauma Center for treatment. But slowly, Children’s Hospital has been working more of those patients into its day-to-day services.

“It’s not an easy balancing act,” Morrow said. “The Children’s Hospital doesn’t have extra space, and when you begin to see children for these types of injuries, you begin to see some of the societal problems that come with victims of gang activity and violence.

“Even after July 2, the adult trauma service will continue to see those age 16 and older who have penetrating traumatic injury.”

Becoming a Level 1 Trauma Center for children under 16 is a reflection of a tremendous amount of work from many different people and services, says John Brock III, M.D., surgeon-in-chief for Children’s Hospital.

“It is through Steve Morrow’s leadership that this service is coming to fruition, and we are truly indebted to the outstanding trauma services across the organization led by John Morris and Rick Miller for helping us make this a reality. This process allows us to see what an incredibly collaborative group we have in the Vanderbilt community.”

It promises to be a busy program. Broering estimates they will see more than 200 pediatric Level 1 Trauma patients in the program’s first year.

“We really wanted to have the capability to focus on a continuum of care for pediatric level one trauma patients, even on to discharge and helping them to find community resources they may need when they leave here,” says Broering. “And as a Comprehensive Regional Pediatric Center, the Children’s Hospital wants to do outreach programs at other hospitals and work with the state and federal government on trauma legislation.”

The application to the ACS will culminate in a site visit and intensive review by representatives from the group’s Committee on Trauma next spring or summer.

“If we get that designation it will really be a feather in our cap, putting us in an exclusive category for level of trauma care for children,” Morrow says.

Media Contact: Carol Bartoo, (615) 322-4747

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