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A revitalized trauma section increases staff and improves care in emergency cases

Yale Medicine Magazine, 2009 - Spring


On February 16, 2007, Quinnipiac University senior Benjamin Shapiro was driving down a secondary road in Hamden, Conn., at about 1 a.m. when his car slid across four lanes of traffic, crashed through a chain-link fence, flipped over a concrete barrier, slid down an embankment and landed in the Mill River. He spent the next 20 minutes submerged in icy water.

“When they pulled him out of the water there was no heartbeat, no pulse, nothing,” said Shapiro’s stepmother, Joan Abrams. Shapiro had suffered a brain injury, the bones in the left side of his face were crushed and his left eyeball was hanging by a tendon. Doctors put his chances of survival at well below 10 percent.

The Department of Surgery’s Section of Trauma, Surgical Critical Care and Surgical Emergencies, which was recently revamped under the direction of Kimberly A. Davis, M.D., was prepared to deal with an emergency of this magnitude.

“Everyone who is a full-time member of this section is board-certified or eligible in both general surgery and surgical critical care,” said Davis, who took over as section chief in June 2006. “With attending-level surgeons in the hospital at all times, we can take care of anything that comes our way, 24/7.” This also means faster evaluation and response times and improved communications between caregivers as well as with family members.

“With Kim’s appointment, our Level 1 trauma center has become a comprehensive acute care service, where physicians are able to function in all three areas: urgent general surgery, critical care and trauma, and that has made a huge difference in our service to the community,” said Tucker Leary, vice president of administration at the hospital.

Under Davis, the number of surgeons has nearly doubled, to seven full-time surgeons providing trauma, critical care and emergency surgery. Davis is planning to fill an eighth position soon. She also initiated a weekly meeting to review cases and discuss what worked and what might have been handled differently.

And the investment is paying off. The year before Davis’ arrival, the section evaluated 2,550 patients and admitted 1,650. In 2007-2008, 3,800 trauma patients were evaluated and 2,400 were admitted. The survival rate of trauma center patients is 95.6 percent, above the national average of 94 percent.

One of those survivors is Shapiro, who spent nine days in a medically induced coma, followed by surgery to rebuild his face and save his eye. He was able to return to Quinnipiac as a full-time student and graduated with his class that May.

“I look back on the day of my accident and as horrible as it was, I view it as the single best day of my life,” he said. “Now, whenever someone says to me, ‘How are you doing?’ I can always say, ‘Great.’”

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