Emergency response to trauma makes life or death difference
An ambulance arrives at the scene of the shootings in Atlanta on Thursday|
|The injured were taken to Grady Hospital, the only Level 1 trauma center in Atlanta. CNN's Holly Firfer explains why.
July 30, 1999
Web posted at: 10:47 a.m. EDT (1447 GMT)
From Correspondents Dr. Steve Salvatore and Holly Firfer
ATLANTA (CNN) -- Emergency medical response to incidents
involving multiple casualties, such as the Atlanta area shootings Thursday afternoon, emphasize the importance of two
key elements: training and speed.
Medical professionals say there is a "the golden hour" -- a
limited time period that a physician has to restore life
functions quickly to a trauma patient. If that window of
opportunity is missed, fatal brain damage or irreversible
shock will occur.
Trauma centers often not the closest, but the best
Many of the Buckhead shooting victims were transported nine
miles to Grady Memorial Hospital in downtown Atlanta. Grady
was not the closest hospital to the scene, but it is
Atlanta's only level-one trauma center.
To be classified as such, emergency rooms must contain
"things like CT (three-dimensional X-ray) scanners," Grady Hospital's Dr. Leon Haley said. "Angiography, anesthesiology are ready and available where it can be used at a moment's notice."
Specially trained staff must be available 24 hours a day.
Grady's shifts included two board-certified surgeons, seven
or eight residents, nurses and support staff. Other medical
specialties, such as orthopedics and neurosurgery remain on
Atlanta's Grady Memorial Hospital is one of Georgia's premiere trauma centers
On a average day, Grady's emergency room is staffed with
between 10 and 15 people. When word of the shooting reached
the hospital, it was in the middle of a shift change, so
there were close to 40 trauma team members present.
"Depending upon the discipline that the physicians are in --
we will train them according to that discipline," said Haley.
"So the emergency medicine physicians will go through a
three-year training program, the surgery resident will go through a five-year training program."
Level-one trauma centers deal with gunshot wounds, motor vehicle accidents and burns.
Grady's resources were tested in July 1996, when victims of
Atlanta's Olympic park bombing were transported there.
Recently, several Heritage High School shooting victims in
suburban Rockdale county were treated at Grady Hospital.
"We are used to sort of a high volume of trauma," said Haley.
While treating the shooting victims, the center continued to
handle other emergencies in a routine manner.
Minutes, even seconds, are critical
Trauma surgeons agree that an equally important part of
emergency response is the 911 system. It began as a central,
easy-to-remember number, that would provide quick, highly
trained medical response.
Paramedics "scoop and run" in a trauma call. The idea is to
get the patient to the trauma center as quickly as possible,
without wasting time at the scene. That way, patients can get
the specialized attention they require. Paramedics are
especially mindful of "the golden hour."
The "golden hour" concept began during the Korean War.
Doctors noticed that soldiers' survival rates improved
greatly if they were treated within an hour after being
So essential is that time frame, that some trauma surgeons
even refer to a "platinum half hour." This is reserved "for
patients who are at the extremes," said Grady's Dr. David
Feliciano, "and really need immediate resuscitation in the
Why? Atlanta seeks answers for massacre
July 30, 1999
6 injured in Georgia high school shooting
May 20, 1999
Counseling emergency care providers
April 22, 1999
Hospitals respond to emergency
July 27, 1996
Sources: Arrest in Olympic bombing could occur within days
July 27, 1996
Grady Health System
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