Since its inception, the Trauma System has reduced San Diego’s preventable death rate following major traumatic injury from 21 percent to 1 percent.
This year, the San Diego County Trauma System and UCSD Trauma Center celebrate two decades of service to the community. The County’s only American College of Surgeons-ranked Level 1 Center, UCSD Medical Center was originally named a Level I Trauma Center by the Board of Supervisors on April 10, 1984.
The designation was the culmination of several years of leadership and planning by UCSD Medical Center and others, including the San Diego County Medical Society, the Hospital Council and County Department of Public Health. At the same time, the County designated four fully-equipped and professionally staffed Level II trauma centers to form the trauma network: Mercy Hospital and Medical Center, Scripps Memorial Hospital, Sharp Memorial Hospital and Palomar Medical Center, and one pediatric trauma center at Children’s Hospital and Health Center.
In 1982, accidents were the leading cause of death in the County, and studies revealed that 21 percent of trauma deaths were preventable. Since its inception, the Trauma System has reduced San Diego’s preventable death rate following major traumatic injury from 21 percent to 1 percent.
On July 18, 1984, the incident known as “The McDonalds Massacre,” then the deadliest single day killing spree in U.S. history, occurred in San Ysidro with 21 people killed and 19 injured. The Trauma System went into action as helicopters transported the three most critically injured patients to the UCSD Trauma Center with gunshot wounds to the head, neck and chest. Two other centers also received patients.
In 1989, Hoyt became acting director of the trauma program, and was named Chief of the Division of Trauma/Burns in June 1990. Hoyt had been an active participant in the establishment of the San Diego County Trauma System and continues to be a national leader in trauma care. He also was instrumental in helping UCSD Medical Center achieve and maintain designation as the Level I Trauma Center with the resources available around the clock to handle the most severe injuries.
UCSD Trauma nurses
One of the ways UCSD Trauma Center maintains continuity of care is through a trauma nursing structure that assigns one trauma nurse to remain with a trauma patient from admission until the patient is stabilized, often through surgery and intensive care.
The UCSD Trauma Center system relies on teamwork among the core trauma team of surgeons, which includes Hoyt, Raul Coimbra, M.D., and Bruce Potenza, M.D., intensive care specialists, ED staff, nurses, and anesthesiologists, and also specialists in orthopaedics, neurosurgery, obstetrics, and burn care who are consulted as necessary. Throughout a patient’s stay at UCSD Medical Center, the trauma team remains apprised of the patient’s progress.
Another important component of the UCSD Trauma Center is its training program for medical students. Each year the system trains approximately 50 UCSD School of Medicine students, 50 to 60 surgical residents and interns, and two postgraduate fellows. The students are exposed to a wide variety of cases and to the most advanced technology.
Researching better treatments for trauma patients that will improve healing and lower infection rates among trauma survivors is also a priority. UCSD Trauma Center has been a leader in the evaluation and treatment of immunosuppression following injury, and has participated and helped develop alternative resuscitation fluids for the acutely injured, and discovery the effects of hypertonic saline on reversing immunosuppression. Today, it is the first of 10 trauma centers nationally to evaluate the use of blood substitute derived from outdated human blood in the treatment of patients in the field.
From the McDonalds Massacre in 1984 to the San Diego firestorms last year, the trauma staff has cared for patients injured in major disasters and nearly 32,000 patients in-between.
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