Likely first Level 1 pediatric trauma center opens

Monday, July 2, 2007 at 1:51pm

One of the nation’s top facilities for treating children during the “golden hour” immediately after serious injury opens today in Nashville.

The Monroe Carell Jr. Children's Hospital at Vanderbilt today began work at a trauma center seeking certification by the American College of Surgeons as “Level 1” facility, the top accreditation possible for trauma centers.

It would be the first Level 1 pediatric trauma center in the state, and one of only 15 in the nation.

“It's a difficult designation to earn,” said Stephen Morrow, medical director of the program.

The trauma center is open for treatment of high-level trauma injuries – from situations including house fires and car accidents – 24 hours each day. The facility complements VUMC’s main trauma center and burn unit by providing focused care for children. The adult center will continue to see those age 16 and older.

“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 said.

“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,” said 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.”

VUMC expects the center to be busy, with about 200 patients anticipated in its first year.

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.

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, formerly trauma coordinator at Vanderbilt University Hospital, is 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.

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 said.

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