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Understanding trauma care

November 17, 2000

Hospital lingo: Understanding trauma care



Dr. Marc E. Kross is trauma director at Washington County Hospital in Hagerstown, one of five Level II trauma centers in Maryland. It is only one of 10 Level II centers in "rural cities" in the entire country, according to Kross. It's rare to have such a high level of care in a rural area, he said.

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There is a trauma surgeon on call 24 hours a day, Kross said. Clinically, the trauma center at Washington County Hospital can handle everything but some complex pelvic injuries and thoracic-aortic tears. The center does not do cardio-pulmonary bypass and also will refer some pediatric traumas to specialists at the pediatric trauma center at Johns Hopkins Hospital in Baltimore.

However, area patients in such situations may be brought to Washington County Hospital first.

The "ABCs" of trauma are airway, breathing and circulation, according to Kross. The patient has to be "stable" in these areas before being transported, Kross said.

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The "land providers" of emergency transportation - Community Rescue Service, for example - and state police helicopters have staff trained to help determine where an injured person will be taken.

Washington County Hospital is part of the Maryland State Trauma Network, and Kross is completing the final year of his three-year term as president. Trauma centers are "professionally friendly," Kross said. Each knows its capabilities and the capabilities of other centers. The Maryland system is looked upon nationally as a standard-setter, Kross said.

Specialized trauma care is important, Kross believes. He cited a study that reported a reduction in the rate of preventable death from 20 to 1 percent with specialized trauma care. Trauma physicians have fellowship training. They treat everything as an emergency. They know what to do and do it quickly, he said.

It is very stressful at times, Kross said. "You have to like the action."

- Kate Coleman, Staff Writer

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