Preparation, Teamwork and Technology Help Make Remarkable Care Possible

Med FlightMadison, Wisconsin - You've probably seen the ads on TV: Inspiring 30-second montages of words and images that describe UW Health as "Remarkable."


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What the ads don't convey is the preparation, stellar teamwork and advanced technology that make "Remarkable" happen. That story is better told through the experience of a recent patient.


Recently, paramedics at an accident scene north of Madison found an older adult trapped inside a car. After a 20-minute extrication and rush to a local emergency department, evaluation revealed traumatic aortic injury and internal bleeding with severe pelvic and neck fractures. Within minutes, the patient was prepped for transport and on the way via helicopter to UW Hospital and Clinics.


And the Top 10 reasons the patient's care was remarkable are...


10. Regional relationships - A UW Hospital and Clinics trauma resident was on rotation at the time with a Fox Valley surgery group. She connected quickly with UW Hospital and Clinics trauma chief resident Sara Buckman, MD, who began immediately to assemble the people and resources needed in Madison.


9. Advanced treatments - The patient's aortic tear made the patient a candidate for the first post-investigational use in Wisconsin of TEVAR (a stent used for Thoracic EndoVascular Aortic Repair), performed on a trauma patient. Access to this leading-edge use of TEVAR at UW Hospital and Clinics is even more remarkable because...


8. Clinical research - Clinical trials for TEVAR were performed at UW Hospital and Clinics, so our physicians had experience with the device. Dr. Girma Tefera, the UW principal investigator, has published peer-reviewed articles and chapters on its use in trauma cases, which the FDA approved in January 2012. The lab at UW School of Medicine and Public Health reviewed radiographic images from all sites in the nationwide clinical trial. UW Health was in an excellent position to care for this patient because we've been at the center of developing this treatment option for trauma patients and establishing its clinical value for all patients in the U.S.


7. Trauma readiness - As a Level I Trauma Center, UW Hospital and Clinics has trauma care specialists and a dedicated trauma OR available 24 hours a day. Equipment and resources such as clinical laboratory services are also available at a moment's notice. The angiography-equipped OR made it easy to quickly assess the patient's pelvic and cervical vessels and the bleeding pelvic fracture.


6. Networked imaging technology - During air transport, the trauma team in Madison took maximum advantage of the technology in place for just these types of cases. Using our remote access network, and PACS (Picture Archiving and Communication System) imaging system through ImageShare, physicians reviewed CT images from the transferring hospital without the need to wait for them to arrive with the patient. Having this critical information in advance, and having the ability to network via mobile phones, they were able to make important time-saving decisions in advance.


5. Specialized clinicians - Highly trained individuals like cardiovascular anesthesiologist Dr. Joshua Sebranek, trauma surgeon Dr. Ann O'Rourke, and robotic fluoroscopy technician Katie Murray, were called in as soon as the films were viewed and the need identified. They were present before the patient arrived at UW Hospital and Clinics.


4. Expert clinical creativity - The expert skill and effort of Dr. Sebranek and his team made it possible for the patient to have TEVAR performed under local anesthesia. For the older adult arriving in shock, with a low heart rate, low blood pressure and multiple traumatic injuries, this expert care spared the patient general anesthetic with intubation that would have been hazardous given the cervical fracture and open chest surgery that could have aggravated pelvic bleeding.


3. Experienced weekend surgical staff - UW Hospital and Clinic's experienced weekend surgical services staff clicked flawlessly into action. Sally Temple, an experienced surgical services nurse familiar with aortic emergencies, organized a team that included Jessica Limberg, Marcie Fenne, Robyn Peterson, Terry Wilde, and Drs. Joe Bobadilla and Melissa Ertl.


2. Smooth handoff from the OR to the TLC - Surgical ICU resident Lucas Rifkin, under supervision of Dr. MaryClare Sarff, came to the OR to insure a successful transition to the TLC. The careful face-to-face handoff ensured TLC staff would be thoroughly familiar with the patient's immediate needs and challenges.


1. Awesomely choreographed and compassionate teamwork - From emergency transport through the ED, OR and TLC, UW Health's amazing, high-functioning team of professionals reviewed images, placed lines, prepped the field, resuscitated and treated an awake patient with multiple serious, life-threatening injuries and successfully transitioned the patient to the ICU for follow-up care. Dr. Buckman, the chief resident who took the initial call, remained with the patient from arrival in the ED through treatment in the angio OR and on to TLC, providing comfort and continuity.


Date Published: 03/09/2012

News tag(s):  emergency

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