Trauma Awareness Month Reminder: Trauma Can Be Prevented If Proper
Precautions Are Taken
the American Trauma Society, trauma is the leading cause of death for
all individuals under the age of 40 in the United States. With June
as National Trauma Awareness Month, these statistics serve as a reminder
that trauma may be deadly, but it also can be prevented with proper
precautions such as mandated safety belt use and the lowering of speed
limits. Trauma Awareness Month is designed to raise national attention
to trauma and what must be done to reduce the devastating impact of
Emory University School of
Medicine trauma surgeons at Grady Memorial Hospital make every precaution
to ensure that people are aware of the dangers associated with trauma.
As the largest Level I trauma center in the state of Georgia, more than
85 percent of major trauma cases in the metro Atlanta area are treated
at Grady Hospital. Of the trauma cases seen at Grady, one-third involve
penetrating trauma of gunshot wounds and stabs; the other two-thirds
include blunt trauma involving car crashes, assaults, falls, etc.
"Many people pay no attention
to trauma," David V. Feliciano, M.D., Emory University School of Medicine
professor and chief of surgery at Grady Hospital. "They worry about
getting old and dying of cancer, heart attacks and strokes. What people
need to remember is if they're young, the most likely cause of death
of a friend is a car crash or shooting. If they're a parent, the most
likely cause of premature death of their child is trauma. Trauma has
a much bigger ripple effect on American society than people realize,
because so many of the patients who die are young."
According to the National
Safety Council's Injury Facts, unintentional trauma causes 95,000 deaths
in the United States each year. Of this number, nearly 45 percent are
attributed to motor vehicle crashes, while other causes include falls,
poisoning, fire, and drownings. Intentional trauma including suicides,
homicides, and police shootings accounts for another 55,0000 deaths
each year. Therefore, there are 150,000 trauma deaths in the United
States each year.
Dr. Feliciano says that most
trauma is preventable. Much improvement has resulted from campaigns
warning of the dangers of drinking and driving, as well as the lowering
of speed limits on highways, and laws requiring drivers and passengers
to wear seat belts. Dr. Feliciano notes that deaths related to motor
vehicle crashes in the United States, for example, decreased by 23 percent
from 1972 to 1996. In 1972, the National Safety Council reported 56,278
deaths involving motor vehicle crashes; in 1996, that number had dropped
"There's a lot more push
with prevention these days with attempts to reach school children and
high school kids who are starting to drive," Dr. Feliciano said. "Clearly,
prevention will have a big impact if everyone focuses on it."
Grady admits as many as 3,800
trauma patients each year, and tallies twice as many admissions than
the other three Level I trauma centers in Augusta, Macon, and Savannah.
Level I is the designation used by the American College of Surgeons'
Committee on Trauma and refers to the availability of physicians in
all specialties to care for trauma patients 24 hours a day. "It puts
a hospital like Grady on a special plateau. Many hospitals simply cannot
produce a specialist in every specialty 24 hours a day," Dr. Feliciano
There are six Emory surgeons
who have been trained in both trauma and/or surgical critical care after
the completion of their training in general surgery. An attending surgeon
is in the hospital, for example, 24 hours a day, every day, throughout
the year. The surgeons, all of whom are full-time Emory University School
of Medicine faculty, have received extensive training beyond their residency
training, and are board-certified by the American Board of Surgery in
surgery and in surgical critical care. They are equipped to handle all
major traumas, including those involving children, burns, and police.
Emory surgeons care for 85 percent of all trauma patient care seen at
Grady. The remaining 15 percent receive care from surgeons with Morehouse
School of Medicine.
"It's unusual for a group
this size in a public hospital to be as well-qualified," Dr. Feliciano
said. "It's sheer dedication. You can't run a trauma center with our
volume by having the attending physicians at home in bed. It just doesn't
In May, researchers from
Emory and Morehouse began enrolling patients in the world's first clinical
trial of the hormone progesterone as a treatment for moderate to severe
traumatic brain injury. The three-year pilot study is called "ProTECT,"
which stands for Progesterone for Traumatic brain injury, Experimental
Clinical Treatment. It has been approved by the U.S. Food and Drug Administration
and is funded by the National Institutes of Health (NIH).
As a community, county and
statewide resource for trauma care, Emory only receives a modest amount
in compensated care from Fulton and DeKalb counties, yet receives no
funding from the state of Georgia. In 2001, Emory physicians provided
$10.6 million in uncompensated trauma care for which there was no reimbursement.