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Inside Eastern Wisconsin's Only Adult Level I Trauma Center

Marc de Moya, MD, trauma surgeon, and Terri deRoon-Cassini, MS, PhD, trauma psychologist, provide a unique look inside the Trauma Center at Froedtert Hospital in this two-part series from Wisconsin Public Radio.

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When an adult suffers a traumatic injury, our Trauma Center is ready to respond 24 hours a day. The Trauma Center combines the latest technology with exceptional staff to provide the highest level of care to trauma patients in the region.

It is the only adult Level I Trauma Center in eastern Wisconsin. Severely injured patients from as far away as Pierce, Rusk and Oneida counties in Wisconsin are brought to the Trauma Center for life-saving care.

What Is Trauma?

Trauma is any serious injury caused by an external force, such as a motor vehicle crash, falls, violence, sports- or recreational-related injuries and job-related injuries.

What Does “Level I” Mean?

The Trauma Center is classified as “Level I,” which means it provides the highest level of specialty expertise and meets strict national standards. Specialized teams, facilities and equipment are available around the clock, 365 days a year, to treat life-threatening injuries.

A trauma center is not the same as a hospital emergency department; emergency services are a critical component of a comprehensive trauma program. A Level I facility must have the capability of providing total care for every aspect of injury, from injury prevention to rehabilitation.

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A Level I trauma center is required to:

  • Have prompt availability of specialists in trauma surgery, orthopaedic surgery, neurosurgery, surgical critical care, rehabilitation medicine and emergency medicine to adequately respond to and care for the various forms of trauma. In addition, specialists in anesthesiology, radiology, plastic surgery, oral and maxillofacial surgery and internal medicine also need to be readily available.
  • Have an operating room dedicated solely to trauma patients.
  • Provide injury prevention programs in the community.
  • Provide professional education for physicians, nurses, emergency medical services personnel and physician liaisons.
  • Conduct resident training in general surgery, orthopaedic surgery and neurosurgery.
  • Conduct research — a commitment to research is primarily what separates Level I trauma centers from Level II trauma centers. At Froedtert & the Medical College of Wisconsin, a strong relationship between Medical College of Wisconsin researchers and care providers keeps the Trauma Center on the leading edge of the latest advances in trauma care.

Level I trauma centers in most states, including Wisconsin, are designated by the American College of Surgeons (ACS) for three-year periods. Lower levels of trauma care are provided by trauma centers that have Level II, Level III and Level IV designations.

Stop the Bleed logoOur Trauma Center offers "Stop the Bleed" information and training. Stop the Bleed training can help you save a life if you're a bystander to trauma. The goal is teach you how to stop uncontrolled bleeding with basic hemorrhage control techniques, such as pressure, packing or a tourniquet.

Trauma Center Statistics

In 2018, 3,454 severely injured patients were seen in the Trauma Center. The Froedtert & MCW health network is proud to support this vital community resource to improve the health of the populations we serve.

  • Falls remained the greatest cause of traumatic injury among patients at the trauma center, accounting for 42% of cases — closely followed by motor vehicle and motorcycle crashes (26%).
  • Most patients (56%) in 2016 arrived at the Trauma Center via advanced life support transport (paramedic).

Read the Trauma Center Annual Report

Regional System of Care

The Trauma Center is the hub of a complete system of care serving the entire region. Before a patient arrives at the Trauma Center, many other professionals are involved, including:

  • Skilled 911 dispatchers
  • Firefighters and police officers, who are often the first to respond at the scene of an injury
  • Paramedics, who perform life-saving care and transport patients to the Trauma Center
  • Flight For Life, staffed with flight nurses and flight paramedics or physicians for rapid transport of patients to the Trauma Center from an injury scene or transfer from another hospital.

The Trauma Center is a member of regional and state organizations dedicated to coordinating trauma care and preventing injuries, including the South East Regional Trauma Advisory Council (SERTAC). In addition, Medical College of Wisconsin faculty members hold positions on the state Trauma Advisory Committee, the state EMS Physician Advisory Committee for the Wisconsin Department of Health Services, and serve as the current State Trauma System Medical Director.

The Trauma Team

Upon arrival, all patients are met by the trauma team, which is staffed and ready at all times. The team approach to the care of trauma patients is critical; each team member has a specific role to perform under the direction of the trauma team leader.

We quickly assess patients for major injuries. If injuries affect more than one organ system, a patient is admitted to the trauma service. If injuries are to a single system, the appropriate program, such as neurosciences or cardiology, assumes care of the patient.

Our highly trained trauma team means that all staff who need to care for patients will be at the patients side in their most critical moment — from the trauma surgeon who performs emergency surgery, if needed, to the neurosurgeon who treats a head injury or the chaplain who waits with family members.

Our rehabilitation team provides an early evaluation from a medical and functional perspective to help surgeons determine the necessary rehabilitation interventions. A physical medicine and rehabilitation physician (physiatrist) evaluates patients with brain, spinal cord, orthopaedic or multiple trauma injuries in the intensive care unit, sometimes within 24 hours of their injury. This early contact provides an opportunity for patient and family education about the patient's future needs. These early discussions help patients achieve their maximum recovery.

Trauma Center Activations

First responders from Emergency Medical Services (EMS) evaluate injured patients at the site of the trauma. EMS Communications then initiates one of three “activations” depending on the condition of the patient and the mechanism of injury:

  • Trauma Alert: When a person has sustained a traumatic injury and is showing poor vital signs, EMS Communications pages a “Trauma Alert.” Key indications include low blood pressure, abnormal heart rate, signs of coma, compromised breathing and any gunshot wound to the neck, chest or abdomen. A Trauma Alert activates the full trauma team, including trauma surgeons, emergency medicine physicians and nurses, OR and Surgery ICU staff and Versiti staff.
  • Trauma Call: When a person has suffered a serious injury but his or her vital signs are normal, EMS Communications pages a “Trauma Call.” This page activates a subset of the trauma team, including surgeons and emergency medicine physicians and nurses.
  • ED Alert: Individuals involved in a crash or fall may not appear to be significantly harmed, but they still have the potential for serious injury. In these cases, EMS Communications pages an “ED All” to notify Emergency Department physicians and nurses that a patient who may need significant attention will arrive soon. All potentially injured patients who are pregnant or over the age of 65 trigger an ED Alert.