For many of the 53 victims injured in the Orlando massacre earlier this month, their visit to the closest trauma center -- at Orlando Regional Medical Center, just three blocks away -- was most likely critical to their survival. (Fifty more, counting the gunman who was killed by police, were shot dead inside Pulse nightclub before dawn on June 12.)
Trauma centers are specially equipped and organized -- with critical staff on hand at all times and multiple backup teams at the ready -- to treat severely injured patients, whether they’ve been injured a car crash, fireworks accident, or mass shooting like in Orlando. They are accredited by the American College of Surgeons and licensed and regulated by the state. Level I trauma centers are larger, prepared to handle greater volume, and often associated with research institutions or university-affiliated hospitals; Level II centers provide the same level of care, but treat fewer patients each year.
In New Jersey, there are three Level I facilities and seven Level II trauma centers, distributed throughout the state based on population and geography. Staff at these sites work closely with police, firefighters, emergency medical technicians -- including medical airlift teams -- and colleagues at other emergency rooms to ensure that victims with serious burns, gunshot wounds, contusions from accidents or violence, and other traumatic injuries are routed to the closest trauma center for treatment.
“If you’re a, you get the same care at a Level I or a Level II,” noted Dr. John M. Porter, a trauma surgeon who is Medical Director of the Cooper University Hospital Level I Trauma Center in Camden.
In New Jersey, Level I centers must treat at least 600 patients a year, while Level II facilities must see at least 350 annually. Data has repeatedly shown that the more patients a practitioner treats, the better they do clinically. (Cooper, established in 1982, admits more than 2,700 patients a year, which representatives said makes it the highest volume center in New Jersey.)
Porter said that while many hospital emergency rooms have the trained staff and equipment to treat traumatic injuries, they do not have all members of the response team on hand 24/7 or the same level of redundancy.require surgeons, anesthesiologists, critical-care nurses to eat, sleep, and remain onsite during their shift, he said.
“At other hospitals they have to call everybody in,” he explained. “And if time is of the essence, while they’re calling people in, you’re bleeding to death and dying.”
Trauma centers are in the business of preparing for the worst. Dr. Porter said all facilities must have a disaster plan to deal with mass-casualty events, like the Orlando shooting, and they train to coordinate with other trauma centers and emergency rooms for regional disasters. When the Amtrak train veered off the tracks in Philadelphia last spring, the Cooper team was ready if it needed to pitch in, he said. (They did not -- that time.)
Trauma surgeons also stay in touch nationwide, networking at conferences and chatting online, Dr. Porter said, noting that it’s a small community of professionals. With some two decades of trauma center experience, he knew four of the five surgeons at Orlando Regional Medical Center who were on television in the days following the shooting.
“We’ve always been ready to do this -- it’s just no one knew because these things weren’t in the news,” the Camden resident said. “It was better in the past when we were ready and not having to use these things.”
Level I Trauma Centers
Cooper Hospital/University Medical Center, Camden
Robert Wood Johnson University Hospital, New Brunswick
UMDNJ-University Hospital, Newark
Level II Trauma Centers
AtlantiCare Regional Medical Center, Atlantic City
Capital Health System -- Fuld, Trenton
Hackensack University Medical Center, Hackensack
Jersey City Medical Center, Jersey City
Jersey Shore Medical Center, Neptune
Morristown Memorial Hospital, Morristown
St. Joseph's Hospital and Medical Center, Paterson