R Adams Cowley Shock Trauma Center

R Adams Cowley Shock Trauma Center
University of Maryland Medical System
Geography
Location	Baltimore, Maryland, USA
Organisation
Care system	Private, Medicare, Medicaid
Type	Specialist
Affiliated university	University of Maryland, Baltimore
Services
Emergency department	Level I trauma center Primary Adult Resource Center (PARC)
Beds	100+
Speciality	Trauma
History
Opened	1960
Links
Website	http://www.umm.edu/shocktrauma

R Adams Cowley Shock Trauma Center (also known simply as Shock Trauma or Shocktrauma) is a free-standing trauma hospital in Baltimore, Maryland and is part of the University of Maryland Medical Center. It was the first facility in the world to treat shock. Shock Trauma was founded by R Adams Cowley, who is considered the father of trauma medicine.

Early years

While serving in the United States Army in France immediatedly following World War II, Cowley found that many severe injuries could be stabilized if the patient could be transported to a military hospital, where a surgeon was present, within one hour of the initial injury. Dr. Cowley coined the phrase "golden hour" to describe this crucial period of time. Dr. Cowley lobbied the legislature in Maryland to purchase helicopters for the transport of trauma patients. When the Maryland legislature denied his request due to the cost of helicopters, Dr. Cowley was able to persuade the State of Maryland to purchase helicopters by agreeing to share them with the Maryland State Police. Today, almost all major trauma centers in the United States employ helicopters to transport trauma patients to the hospital.

During the early years of the trauma center, R Adams Cowley fought with the medical community to change the policy of "nearest hospital first," which was prevalent at the time. In the early 1970s, first responders would take all patients to the nearest hospital emergency room. The flaw to this system was that the nearest hospital was usually not capable of treating severe trauma. In 1975 a young prosecutor named Dutch Ruppersberger was involved in a nearly fatal automobile accident, and his life was saved after he was transported directly to Shock Trauma (not the nearest hospital). Mr. Ruppersberger ran for public office, in part to advocate the trauma facility. The "nearest hospital first" was eventually abandoned, and emergency medical systems across the United States now follow the model first advocated by Shock Trauma.

Facilities

Shock Trauma houses over 100 inpatient beds dedicated to emergency surgery, resuscitation, intensive care, and acute surgical care. The facility boasts a dedicated resuscitation area in excess of 12 beds. The Trauma Resuscitation Unit (TRU) is located on the building's second floor. Helicopters and ambulances bring injured patients directly to the TRU for emergent treatment and stabilization. Specialized trauma teams composed of trauma surgeons, trauma fellows, surgical residents, orthopedic surgeons, neurosurgeons, radiologists, anesthesiologists, nurse anesthetists, emergency-medicine residents, trauma nurse practitioners, other mid-level providers, nurses, and technicians stand ready to receive victims 24 hours a day, 365 days per year. The helipad at Shock Trauma can accommodate up to three medevac helicopters at one time and has direct elevator access to the resuscitation area several stories below.

Adjacent to the TRU is a vast array of equipment and facilities that are immediately available to the patient in extremis. Shock Trauma has six dedicated operating suites in addition to two multislice CT scanners, an angiography suite, and digital plain film capability. The inpatient wards of the Shock Trauma center consist of specialized intensive-care units, intermediate-care units, and regular surgical-floor beds. Shock Trauma can admit patients directly into the operating room if their condition requires it. Intensive care at Shock Trauma is a multidisciplinary endeavor: the facility boasts dedicated beds for victims of multisystem and neurosurgical trauma.

Education

Shock Trauma trains physicians and medical personnel from locations overseas and throughout the United States. The facility hosts emergency-medicine residents from the University of Maryland and Johns Hopkins University and medical schools in Canada. Shock Trauma receives over 7500 admissions per year and provides its residents with intensive training in the evaluation and management of both blunt and penetrating injury.

In May 2007, Dr. Thomas M. Scalea, physician-in-chief for the R Adams Cowley Shock Trauma Center, presented a case at the University of Maryland Medical School's annual historical clinicopathological conference in Baltimore on the assassination of President Abraham Lincoln and whether the world's first center for trauma victims could have improved the outcome had Lincoln's assassination occurred today. 'This could be a recoverable injury, with a reasonable expectation he would survive,' Scalea said, noting that the assassin's weapon was relatively impotent compared to the firepower now on the streets today.

Shock Trauma's educational mission extends beyond the training of future physicians. The facility hosts members of the United States Armed Forces, in addition to providing education for local emergency-medical service providers.

External links

• The R Adams Cowley Shock Trauma Center
• University of Maryland Medical Center
• The University of Maryland Residency in Emergency Medicine
• Maryland Institute for Emergency Medical Services Systems
• Maryland State Police Aviation Command
• University of Maryland Medical System
• University of Maryland Medical School's Annual Historical Clinicopathological Conference