Level I Adult and Pediatric Trauma Care at HCMC
Located in downtown Minneapolis, Hennepin County Medical Center (HCMC) is a public teaching and research hospital committed to providing complex trauma care for adults and children.
Verified by the American College of Surgeons in 1989, HCMC is Minnesota’s first Level I Adult and Pediatric Trauma Center, and was one of the first in the country. HCMC is a nationally recognized, high-volume trauma center, and cares for thousands of trauma patients each year. Patients are referred primarily from the upper Midwest region, as well as nationally and internationally.
As a Level I Adult and Pediatric Trauma Center, HCMC must ensure that trauma surgeons, operating rooms, specialty surgical services, emergency medicine, radiology, transfusion services, laboratory and all services needed to care for seriously injured patients, are available 24/7.
What is a Level I Trauma Center?
- Access to specialists is crucial. A dedicated team of physicians and other providers specially trained to care for critically injured trauma patients are available 24/7.
- Experience is mandatory. To be verified, a center must treat a minimum number of trauma patients each year as determined by the American College of Surgeons.
- Trauma patients are a priority. Operating rooms and support services must always be ready to care for adults and the special needs of children.
- Highly-trained teams are in place. Physicians, nursing staff and the entire trauma team are required to have advanced training in adult and pediatric trauma.
- Research. Cutting edge research conducted to continually improve and set the standard of care through-out the world.
- Prevention and public education. Programs are continually developed to prevent and reduce traumatic injuries when injury trends are identified.
- Collaboration. Work with rural referring facilities to provide life and time saving access to information, education, and care.
- Comprehensive care. Care coordination for patients to assist with integration back into their home community and schools after an injury.
- Performance Improvement. Comprehensive data registry monitors care provided to improve the outcomes for patients and families.
History of Level I Adult and Pediatric Trauma care at HCMC
In 1989, Hennepin County Medical Center was the first hospital in Minnesota to qualify as a Level I Adult and Pediatric Trauma Center under the national standards that had been developed by the American College of Surgeons (ACS). As a Level I Adult and Pediatric Trauma Center, HCMC achieved this distinction because operating rooms, surgeons, imaging, labs, and all the services needed to care for seriously ill or injured patients are available 24/7. HCMC’s recent Trauma Medical Director, Dr. Arthur Ney says, “We see a lot of patients with injuries that involve multiple systems. A single patient may come in with broken bones, a traumatic brain injury and internal injuries that require the care of multiple specialists. The availability of a team of experts working with the right specialist, at the right time, for patients with complex injuries is what sets us apart from non-trauma centers.”
Becoming a world-class trauma center didn’t happen overnight. The innovative groundwork for achieving Level I Adult and Pediatric Trauma status began many years before ACS verification existed. Dr. Ernest Ruiz, Chief of Emergency Medicine from 1972 – 1992, and others championed the development of Emergency Medicine as a specialty and the rapid assessment of the injured patient. He was instrumental in establishing the trauma stabilization room, now the standard in Emergency Departments across the US, where complex emergency procedures and other treatments can be performed as soon as the patient reaches the hospital.
“Over the years,” explains Dr. Ney, “technology advances have significantly improved care. Imaging advancements mean we can diagnose problems faster. We can treat people faster and with less invasive technologies, so recovery is faster. We have multiple blood and coagulation products available in our resuscitation area. Pre-thawed universal donor plasma is available at all times so that we can immediately initiate therapy to correct lost coagulation factors. We have superb Emergency Medical Services that know how to start treatment in the field and physicians at other hospitals who can stabilize patients and make it safe for them to travel for critical care.”
“HCMC has a long history of providing exceptional care to critically injured patients,” says Dr. Chad Richardson, the current Trauma Medical Director. “It takes a tremendous institutional commitment to address the needs of every trauma patient and maintain the rigorous Level I Adult and Pediatric Trauma Center requirements established by the ACS. I recognize the great work that everyone has done over the past 25 years to make HCMC a special place for trauma care. That commitment and institutional pride continues to inspire our trauma program to further improve care.”
Acute Services Include:
- Over 80 Emergency Services beds, including 4 critical care bays, pediatrics, and psychiatric services.
- Trauma surgery specialists with 24-hour Operating Room coverage and 5 specialty Intensive Care Units.
- 24-hour medical imaging services and interventional radiology, along with a combined Interventional Radiology / OR Suite
- New Intensive Care Units for both adults and pediatrics offer private rooms and family support amenities. 50 Critical Care beds including SICU, PICU and the Burn Unit are dedicated to the care of critically injured patients.
- Comprehensive care teams with Occupational Therapy, Physical Therapy, Speech Language Pathology, Recreational Therapy, Trauma Psychology, Neuropsychology, Child Life Specialists, and Alternative Medicine.
Unique Programs include:
- Burn Center: 17-bed intensive care unit that provides comprehensive burn, hypothermia, frostbite and complex wound care for adults and children. The Ambulatory Burn and Wound Clinic attached to the Burn Center provides unique, specialized care for outpatients. Verified by the American College of Surgeons and American Burn Association.
- Traumatic Brain Injury Program: Neurosurgery offers specialized care to pediatric and adult patients who have experienced mild to severe traumatic brain injury. Onsite acute rehabilitation is available, and follow-up care is available at the Mild-to-Moderate Traumatic Brain Injury Clinic and Pediatric Brain Injury Program.
- Orthopedics: HCMC’s orthopedic surgeons are international leaders in the care of fractures and injuries to bones and joints with expertise in managing complex fractures in patients with multiple injuries. An onsite research lab with bioengineering and bone physiologists provides a unique resource for clinicians and patients.
- Center for Hyperbaric Medicine: The only multi-chamber HBO facility in Minnesota that is used 24 hours, 365 days per year for emergency treatment of critically ill patients with gas gangrene, carbon monoxide poisoning, air embolism and decompression sickness, and is used daily to treat complex wounds. Member of the Undersea Hyperbaric Medical Society.
- Cardiovascular: A full-range of cardiovascular surgery procedures are offered, including coronary artery bypass grafting, repair and replacement of heart valves, repair of select congenital heart defects, surgical correction of atrial fibrillation, major aortic surgery, and surgical repair of aortic dissections and thoracic aortic aneurysms.
- Primary Stroke Center: Hennepin Stroke Center is a Joint Commission certified primary stroke center and a national leader in the treatment of ischemic and hemorrhagic strokes with some of the fastest clot-busting drug delivery times in the U.S. and nationally recognized rehabilitation care for post-stroke patients.
- Behavioral Health: HCMC provides a full spectrum of psychiatric services for those with behavioral and emotional difficulties. Acute Psychiatric Services is staffed with psychiatrists, social workers, and psychiatric nurses and provides care to those in emotional crisis 24/7.
- Rehabilitation: The hospital- based Miland E. Knapp Rehabilitation Center provides acute rehabilitation to adolescent and adult inpatients and outpatients. Knapp Rehab is recognized by the Commission on Accreditation of Rehabilitation Facilities (CARF) for its excellence in comprehensive rehabilitation care with special accreditation in brain injury and stroke therapy.
- Alternative Medicine: An interdisciplinary blend of traditional Chinese medicine, chiropractic physical therapy offered in a western health care setting. Services provided include acupuncture, chiropractic, chronic pain management, craniosacral therapy, myofascial release, and Physical Therapy.
Types of Patients that Benefit from Trauma Care at a Level I Adult and Pediatric Trauma Center:
- Altered mental status with Glascow Coma Scale <13
- Abnormal Vital Signs – Hypotensive, Tachycardic, Bradycardic, High or Low Respiratory Rate
- Penetrating injuries to the head, neck, torso, and extremities proximal to the elbow or knee
- Chest wall instability or deformity (flail chest)
- Two or more proximal long-bone fractures
- Crushed, degloved, mangled or pulseless extremity
- Amputation proximal to wrist or ankle
- Pelvic fractures
- Open or depressed skull fractures
- Falls >20 feet in an adult and >10 feet or 2 times higher than the height of the child
- High-risk auto crash
- Intrusion >12 inches at occupant site, or >18 inches at any site of vehicle
- Ejection (partial or complete) from vehicle
- Death in same passenger compartment
- Vehicle telemetry consistent with high risk of injury
- Auto vs Pedestrian/Bicyclist thrown, run over, or with significant impact (>20mph)
- Motorcycle crash >20 mph
- Older adults – risk of injury increase after age 55 years
- Children – preferential triage to pediatric capable trauma centers
- Patients on Anticoagulants or with bleeding disorders
- Burns without trauma triage to a Burn Center, with trauma triage to a trauma center
- Pregnancy >20 weeks
Our Trauma Team:
- Trauma Surgeons
- Pediatric Trauma Surgeons
- Emergency Medical Services
- Emergency Medicine
- Orthopaedic Surgeons
- Cardiovascular Surgeons
- Thoracic Surgeons
- Hand Surgeons
- Plastic Surgeons
- Burn Surgeons
- Obstetric and Gynecologic Surgeons
- Urology Surgeons
- Otolaryngology Surgeons
- Ophthalmology Surgeons
- Oral Maxillary Facial Surgeons
- Interventional Radiologists
- Interventional Neurologists
- Certified Registered
- Nurse Anesthetists
- Transfusion Services
- Infectious Disease Specialists
- Pulmonary Medicine
- Internal Medicine Specialists
- Dialysis Teams
- Clinical Laboratory Experts
- Registered Nurses
- Licensed Practical Nurses
- Health Care Assistants
- Health Unit Coordinators
- Clinical Coordinators
- Surgical Techs
- Laboratory Technicians
- Occupational Therapists
- Physical Therapists
- Recreational Therapist
- Social Worker
- Respiratory Therapist
- Speech Language Pathologist
- Trauma Psychologist
- Physical Medicine and Rehab Physician
- Nurse Practitioners
- Physician Assistants
- Child Life Specialists
- Traumatic Brain Injury Coordinator
- Trauma Coordinator
- Pediatric Trauma Coordinator
- Trauma Medical Director
- Pediatric Trauma Director
- Trauma Registry Staff
- Trauma Abstractors
- Trauma Performance Improvement
- Prevention Specialists
- Outreach Educators
- Community Educators
- Research Analysts
- Trauma Referral Coordinators
- Pediatric Brain Injury Coordinator
- EMS Educators