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Surviving Your Drive: UCLA Medical Center is Ready for Trauma

Aired August 25, 2000 - 2:19 p.m. ET


NATALIE ALLEN, CNN ANCHOR: We continue our "Survive Your Drive" coverage with a look at the people and technology committed to saving lives.

CNN's Jim Hill joins us live from Ucla Medical Center in Los Angeles for a tour through the trauma room -- Jim.

JIM HILL, CNN CORRESPONDENT: Natalie, UCLA Medical Center here in Los Angeles is one of 13 trauma centers serving the county. County wide in Los Angeles, we're told 15,500 more or less trauma patients are treated each year. Now we should point out at this juncture that we've dealt a lot with automobile accidents, this is so-called blunt force trauma. In other words, something impacting a person's body or vice versa. There is also what they call penetrating trauma. This would be either gunshot wounds or stabbing wounds. Roughly 35 percent of trauma cases we're told, are penetrating, 65 percent such as automobile accidents, are the blunt force trauma.

Now here at UCLA Medical Center about 90 percent of the cases whether they are penetrating or blunt force come by ambulance. About 45 paces down the hallway from me by my count is the ambulance port, typically a city or a county paramedic unit brings a patient in accompanied by two qualified paramedics. The other way of transport is by helicopter and three floors above us here is a helipad at UCLA Medical Center. The county fire department runs several helicopters keeping one or three of them, I believe, on duty at any given time, so people can be rushed here. The goal being to arrive as quickly as possible but not later than 20 minutes. This is the beginning of so- called golden hour of treatment.

Now we're going to walk you through a hypothetical situation right now. We're going to take a hypothetical case, a 45-year-old man involved in an automobile crash, this person would be suffering from symptoms of head injury and also chest trauma.

To walk us through what happens in the trauma room is one of the nurses who does this every day. This is Kelly Hubbel.

Kelly, you're going to give us an idea of what happens, and one of your colleagues the coordinator of emergency services, Maryland Cohen, will actually do this for us to demonstrate.

KELLY HUBBELL, EMERGENCY NURSE EDUCATOR: Correct, first we would get a little notification that this trauma patient is coming in. And Maryland would come into the room, put on her vest, her lead vest. At that point she would start gathering equipment that is necessary, potential life-saving for this patient. First we would concentrate on the airway.

The patient has a head injury, may not be able to protect their airway. We would use what we call bag valve mask that could assist in breathing. Next you would want to look at inhibation equipment, meaning equipment that would breathe for that patient. We'd put down that throat, have that ready, and again, that's sort of a life-saving type equipment.

This patient, you said, may also have chest trauma, which can be also live threatening. So we would go ahead and have set-up for this patient a tray which we could immediately put a chest tube in this patient, and, also a chest drainage system so if there was blood or air we could immediately get that out of the lung and evacuate it so the patient could breathe on their own.

HILL: So this tray is a prearranged assortment of all that you would need for a particular procedure?

HUBBELL: Correct, it is, and then from there again, given the type of trauma, it sounds like a seriousness of traumas patient would have. We've probably set-up what we call a rapid infuser, a level one, which would infuse fluid very rapidly and warm for this patient if they happen to be losing blood or hemorrhaging.

HILL: So this would be either a saline solution or could be blood?

HUBBELL: Correct, and at that point, the room is pretty much set up. We have drugs and equipment and we'd be waiting for the physicians to arrive.

HILL: OK, thank you very much.

Let's talk now with the intensive care unit nurse. Now this is a person who the patient would be handed off to once the definitive care is given either here in the trauma room or perhaps in an operating room.

Now this is Maureen Jaisel. Maureen, tell me how important it is for the continuation of treatment once the patient reaches you in the ICU.

MAUREEN JAISEL, ICU NURSE: Well, before we even receive the patient, we've already received a report from either the ER nurse or recovery room nurse. So we already have an idea of the injuries and the equipment that we needed. And we have everything all set up.

The patient comes into unit. Two nurses who'll start to hook the patient up to our monitors, while I would go over and quickly do a complete assessment of the patient. Once that is done, then we already have a set of vital signs on the patient and all the monitoring is hooked up. We can take all of our readings and we see if the patient's stable. If the patient's not stable, then we would have to deal with whatever the problem is. We already have a set of orders from the doctors, respiratory therapy is there, patient's hooked up to the respirator. And then we just start doing our care. Once the patient is stable, then we allow the family to come in.

HILL: Now, patients, I would understand, at this point are still critically injured. They could reverse very quickly, could they not?

JAISEL: They could reverse at any moment. And we have continual monitoring on the patient with the alarms. We're continually watching the monitors, plus hand's on assessment while we're doing that.

HILL: OK, thank you very much, that is Maureen Jaisel, one of the ICU nurses who does this sort of thing that you just heard, just about every day here at UCLA Medical Center, one of 13 hospitals set up to give this all-important trauma care -- Natalie.

ALLEN: Thank you, Jill Hill, in L.A.



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