Written by Staff Reports Thursday, May 22, 2014 09:00 am
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ATLANTIC CITY - Nearly 400 healthcare professionals attended AtlantiCare Regional Medical Center’s 16th Annual Trauma Symposium May 5 to 7 at Bally’s Atlantic City Hotel & Casino. Twenty-five experts including those from ARMC, its clinical partners and hospitals/healthcare organizations from across the country, shared best practices for care of the trauma patient in 30 different sessions.
Lee Woodruff, author of New York Time’s best-seller “In an Instant,” and co-founder of the Bob Woodruff Foundation, which supports and honors military families, gave two keynote presentations detailing her family’s own experience with traumatic brain injury. Woodruff’s husband, ABC news anchor Bob Woodruff, suffered a near-death roadside bomb injury while covering the war in Iraq in 2006.
Woodruff’s message was simple: no matter what the circumstance, no matter how tragic, there is always room for hope.
“Bob’s practitioners later told me that there was no way they expected him to survive through the first night after the bombing,” she said. “But even a month into his coma, I was not ready to let go of hope. What does is cost to let someone have faith?” she asked, adding that hope and ‘the end’ are not mutually exclusive. “Maybe hope is a dignified death, or the ability of a patient to say goodbye to his or her loved ones. Hope is negotiating with the psyche and allowing yourself to find peace.”
Woodruff’s story has a happy ending: Bob made a full recovery and returned to his family and to journalism, having since reported on traumatic brain injuries, global news, and American soldiers abroad and at home. To trauma healthcare providers, Woodruff expressed gratitude.
“What you do is remarkable,” she said. “It is one of the highest callings: taking tragedy and turning it into something good. For all of those times that a family member hasn’t said, ‘Thank you,’ I want you to know that we recognize and appreciate what you do.”
Boston Marathon Bombing
Dr. Alok Gupta, M.D., FACS, program director and trauma surgeon, Surgical Critical Care Fellowship, Division of Acute Care Surgery, Beth Israel Deaconess Medical Center, Boston, Mass., lectured on the Boston Marathon bombings and “Lessons Learned from a Novel ‘Mass Casualty Service.’”
“Expect – and prepare for – the unexpected,” Gupta said. “Every patient who survived long enough to make it to the hospital on the day of the bombings survived,” due in no small part to advance planning. “Hospital preparations require that everyone be involved and that everyone has a clearly defined role.”
Beth Israel Deaconess, he noted, conducted seventeen drills in 2013, and included community partners, such as EMS teams and fire departments in many of these.
“It’s important that hospital administration and clinical departments work well together,” Gupta said. “In order for a football team to perform well during a game, the quarterback and the wide receiver must practice together.”
Gupta said none of Boston’s six level-one trauma centers was overwhelmed by the influx of trauma patients on the day of the Boston Marathon bombings.
“There was no chaos at Beth Israel Deaconess; potential for chaos, and emotional upheaval, but no chaos,” he said.
He said Boston activated the Medical Intelligence Center, connecting hospitals, EMS services, and the Department of Public Health, which facilitated communications between the different entities and allowed sharing of medial resources.
Gupta said Beth Israel Deaconess activated what it came to call the “Mass Casualty Service.” The multidisciplinary team of healthcare providers worked to anticipate and address patients with common, evolving needs.
“The MCS allowed us to centralize decision making, and streamline the process of healthcare delivery to the 24 patients admitted to Beth Israel Deaconess,” Gupta said. “It’s reproducible, incident-specific, and can be implemented in any hospital in response to a mass casualty incident.”
From trauma patient to experienced physician
In “A Trauma Survivor’s Blueprint for Success,” Anthony Macchiavelli, M.D., director of the ARMC Hospitalist Program and member of AtlantiCare’s Military Employee Resource Group, discussed his journey from trauma patient to physician.
A graduate of West Point, Machiavelli described his life path as “set.”
“I was very, very happy in the Army,” he said.
This trajectory changed suddenly when the vehicle he was travelling in went off a cliff and blew up while he was on assignment at Fort Hood in Killeen, Texas.
“Evel Knievel would have been proud, but I was pretty banged up,” he said.
Machiavelli was transferred to Walter Reed Army Medical Center, and over the course of a year he had 50 operations, including two major facial reconstructive surgeries.
“I am the luckiest person in this room,” Machiavelli said, offering thanks to the trauma community as a whole for saving his life. “I don’t know how it is that I am alive and here today.”
His experience – which included extensive injuries, burns, acute stress disorder and traumatic brain injury – led him into medicine.
“Part of my psychological recovery was learning to understand my medical treatment,” Machiavelli said. “Studying anatomy was a positive step which helped give me back control of my life through gaining understanding of my care. This is crucial for trauma patients: finding autonomy in a traumatic situation.”
Doctors, he added, should facilitate patients’ empowerment.
“The healthcare system is not built this way, and it is up to us to help patients face their reality, accept a new view of their abilities, and to find a way to add value to their lives at a time when they feel they have little control over their bodies and their healthcare,” Machiavelli said. “The best indicator of a society is how it treats its vulnerable: its young, its old, and its infirm. The single most important lesson I took from my experience was this: allow patients to vocalize their concerns.
“Trauma is physical, but has huge emotional and spiritual aspects as well,” he said. “Ultimately, at the seat of every tragedy lies an opportunity. Encourage your patients to discover their opportunities, and to embrace a new journey.”