STCAnnRepOnline

ANSWERING THE CALL

R ADAMS COWLEY
SHOCK TRAUMA CENTER
ANNUAL REPORT 2014/2015

Reprinted with permission of The Baltimore Sun Media Group. All Rights Reserved.

The R Adams Cowley Shock Trauma Center is
dedicated to treating the critically ill and severely
injured, by employing groundbreaking research and

innovative medical procedures with one

goal in mind – saving lives.

Building On Our Best

The R Adams Cowley Shock Trauma Center is almost 50 years old. We have excelled in both our clinical and
research missions over the years, and we do not intend to stand on past successes. As we look into the future, we
plan to build programs based on a broader definition of injury. Trauma is the quintessential time-sensitive disease.
The Golden Hour has been the motto of both the center and the Maryland trauma system since its inception.
However, other diseases have their own Golden Hour, such as serious infection, compromised blood flow to
virtually any organ in the body, and severe respiratory failure. We recently opened the Critical Care Resuscitation
Unit (CCRU) to provide a conduit for rapid transport of critically ill patients into our center. In addition, our new
Lung Rescue Unit (LRU) provides state-of-the-art care to patients who require advanced support for lung failure.
We have the region’s only Molecular Absorbent Recirculation System (MARS) machine, which provides dialysis for
patients with liver failure similar to hemodialysis for patients with kidney failure. All of these initiatives have allowed
us to bring life-saving therapy to a variety of people with diseases that will not wait.

Every year, nearly 8,000 people are rushed to Maryland’s Shock Trauma Center with life-threatening injuries
from car crashes, motorcycle crashes, falls, industrial accidents, and violence. Today, 96% of those patients
are survivors, because of the innovative, state-of-the-art care we provide at a moment’s notice.

Discovery is an equally vital part of our mission. We have pioneered balloon occlusion to the aorta to control
hemorrhage, as well as defining new and innovative therapy for severe traumatic brain injury. Several national
leaders who are on the cutting edge of defining inflammatory response to injury, as well as rapid cooling of patients
after cardiac arrest in order to protect their brain while injuries are repaired have been recruited.

We continue to extend our education efforts to train those who will follow us, including our service to the military, as
the largest medical training program in the country for the United States Air Force. Even as the winds of war calm
down, we are continuing that relationship to be sure that our American service personnel receive the finest care if
and when it is needed in the future.

Finally, prevention is fundamental to our mission. The Center for Injury Prevention and Policy (CIPP) spearheads a
number of community-based initiatives to help a myriad of people affected by injury, in an attempt to either prevent
or mitigate the burden of injury through education.

The Shock Trauma Center is among the oldest providers of trauma care in the country. The global model for
organized trauma care began in Maryland virtually before anywhere else in the world. Rather than looking into the
past, we eagerly look to the future. While our outcomes are impressive, we will never be satisfied until our mortality
rate is zero. With your support, we will continue to strive towards this goal, always improving our efforts to save the
life of everyone we treat.

Thomas M. Scalea, MD, FACS, MCCM
Professor of Surgery, University of Maryland School of Medicine
Physician-in-Chief, Shock Trauma Center
System Chief for Critical Care Services, University of Maryland Medical System
The Honorable Francis X. Kelly Distinguished Professor in Trauma
Director, Program in Trauma, University of Maryland School of Medicine

Making History Every Day 1961 1963
US Army provides the initial grant to $800,000 National Research
R Adams Cowley, MD hypothesized that early support the first shock trauma unit, Grant awarded to build the Center
medical intervention could interrupt and even a two-bed clinical research unit. for the Study of Trauma.
reverse the body’s shock process.

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When Life is on the Line

A pioneer in open-heart surgery, R A motorcycling couple struck by a bus. A injuries. As the State’s designated referral
Adams Cowley, MD, was a gifted yet high school student hit by a stray bullet. center for such injuries, the Center also
frustrated surgeon, troubled that too A worker whose arm is nearly severed in engages in important research to discover
many of his patients died from shock – an industrial accident. When Marylanders new interventions for severe head and
not always right away, but within days suffer sudden extreme injuries or illnesses, spinal trauma that could improve patient
or weeks after an injury. one name immediately surfaces—Shock outcomes.
Trauma. And with good reason—for nearly
Based upon his studies and five decades, Shock Trauma has been their Our Shock Trauma Outpatient Pavilion
experience, Dr. Cowley believed best hope of survival. (STOP), where patients receive a lifetime
that early medical intervention could of specialized continuing care. The center
actually interrupt and even reverse the As the nation’s first and only integrated is open 5 days a week, with over 18,000
body’s deadly shock process. After trauma hospital, Shock Trauma remains patient visits per year. STOP’s triage line
continued research, he put forward the one of the highest volume trauma centers is managed by a registered nurse who
concept of “the Golden Hour”– a then- in America. Our specialized teams of can answer patient questions related to
revolutionary idea that trauma patients providers work 24/7 to receive, resuscitate, their injury or illness or prescription refills.
would have the best chance of survival stabilize, and treat those whose lives hang Attending physicians are committed to
if they received expert medical care in the balance. In addition, patients who providing care to their patients through
within an hour of their injuries. develop life-threatening complications are their transition to rehab and home. They
often transferred to our Center from other are Shock Trauma patients until they are
Dr. Cowley’s visionary model became hospitals, where our expert clinicians released and ring the bell signifying the
the forerunner of today’s Emergency with advanced technology stand poised conclusion of their treatment.
Medical Services System in Maryland, to respond.
an established framework that The Center for Hyperbaric Medicine
continues to guide the work of Shock Apart from its medical impact, the Center is internationally recognized for its clinical
Trauma to this day. itself has expanded significantly in its leadership in hyperbaric therapy. Offering
physical capacity in order to treat our 24/7 treatment for victims of decompression
growing volume of patients. With the illness, carbon monoxide poisoning,
opening of our new Critical Care Tower in or smoke inhalation, the Center can
2013, six floors of patient care facilities have accommodate 10 stretcher patients or 23
increased our overall space to 340,000 seated patients simultaneously within the
square feet. only multiplace hyperbaric chamber in the
tri-state area. In addition, the Center provides
With this growth, we have been able to medical fitness to dive medical evaluations
maintain such highly specialized services as: and comprehensive physicals to re-certify
recreational, scientific, public safety, and
The Neurotrauma Center which commercial divers.
provides multidisciplinary care to patients
with traumatic brain, spinal column, and
spinal cord injuries, along with related

1967 1969 1970
Plans were made to develop the first The Center for the Study of Trauma was The roof of the garage adjacent to the Center
statewide EMS system. completed and officially opened. was made into a helipad and the first Med-Evac
helicopter transfer was made.
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3

What we learn here...

Kristie Snedeker, DPT, Director of Clinical Operations, Samuel Tisherman, MD, Professor of Surgery; Direc- One night, 22 year-old Kevin Atherley
tor of the Center for Critical Care and Trauma Education; Director of the Surgical ICU, (right) got out of his car to help accident
Jason Bates, MA, Manager Training and Simulation victims on the side of the road. He woke
up in the Shock Trauma Center, his left
At Shock Trauma, we focus on a single re-enter the room, a new crisis confronts leg so severely injured that surgeons had
mission—to eradicate preventable death them – their patient’s blood pressure is now to remove it below the knee. But Shock
and disability stemming from severe plummeting rapidly! Trauma saved his life in more ways than
injury and illness. To achieve that goal, one. “While I was at the University of
we have created a number of training It could be the real thing, but is in fact Maryland Rehabilitation and Orthopaedic
initiatives, including state-of-the-art a high-fidelity simulation in our new Institute, I found myself in bed watching
clinical care services, active research, 10,000 square-foot medical simulation movies a lot,” Kevin says. “Then
didactic and hands-on clinical education, area. Located in our Center for Critical someone told me that I looked like an
and prevention programs. Care and Trauma Education, medical athlete and invited me to try wheelchair
professionals can train to better respond basketball.” That invitation became
Two surgical residents are working feverishly to real-life scenarios they may encounter a turning point for Kevin; following
to save a gunshot wound victim. They in the hospital. The Center includes four rehab, he continued to play with a local
quickly peel off his clothes, probing wounds reconfigurable labs along with three adjacent league and this fall, he is attending
in his leg as blood spills onto the floor. Is classrooms and debriefing areas to promote Pennsylvania’s Edinboro University on a
the patient stable enough to leave alone the highest level of trauma and critical care full athletic scholarship. As a volunteer
for 30 seconds for an x-ray? No consulting education. Thanks to a generous grant speaker at the Trauma Survivor’s
physician is immediately available, so they from CareFirst Blue Cross and Blue Shield, Network, Kevin says with a smile, “I try
make the decision on their own. But as they the Center also features a state-of-the-art to encourage trauma survivors that there
simulation center management system, is life after trauma, and use myself as an
including high fidelity equipment for audio example. Being alive is what matters.”
and video recording in each lab.
Faculty physicians, medical and nursing
students, visiting health care professionals,
emergency medical personnel, and other
specialists can take advantage of the
Simulation Center’s courses on trauma
and critical care management. Over 200
classes were conducted in 2014, including
those accessed by first responders
training to care for patients with traumatic
injuries in their communities.

1973 1986 1989
Executive order issued by the governor of Research showed the U.S. death rate Moved into 6-story Tower
Maryland mandating first statewide EMS was 2.5 times that of Maryland. designed to treat 3500 patients.
system in the country. Shock Trauma received its 20,000th patient.

4

5

...affects what we do there.

Approximately 6 percent of all new C-STARS critically injured soldiers like Adam Keys. The
Society of Critical Care (SCC) fellows For three weeks before they are deployed leading program of only three in the U.S.,
now entering the national workforce are to military zones around the world, US Air C-STARS has generated invaluable research
Shock Trauma-trained. Our Fellowship Force Medical Service personnel – including that benefits both traumas on the battlefield
programs are considered among the surgeons, nurses, and medical technicians and civilian trauma closer to home. Our
best in the world. – come to Baltimore for training at the US location was specifically chosen due to
Air Force Center for the Sustainment of our trauma patient volume, mechanisms of
Our Surgical Critical Care Fellowship Trauma and Readiness Skills (C-STARS) injury and clinical expertise. These civilian/
Program is the largest Accreditation Council at Shock Trauma. Since 2001, the program military partnerships are crucial in keeping
for Graduate Medical Education (ACGME) has provided military personnel with a military medical professionals ready for
training program in the country. In addition, real-world platform for intense, state-of-the- wartime casualty care.
our ACGME-accredited Orthopaedic art training in trauma skills for the care of
Traumatology Fellowship is considered
by many to be the foremost Orthopaedic Photo courtesy Coos Hamburger
Trauma Fellowship in the world. Alumni of
the Fellowship currently lead trauma care In 2011, three years before Kevin Atherley’s accident, Army veteran Adam Keys arrived
and orthopaedic education at numerous at Shock Trauma from Afghanistan by way of the Walter Reed National Military Medical
centers around the world. Center. The survivor of an IED explosion, he lost both of his legs and one arm, while
suffering severe head injuries and burns. Over his six months at Shock Trauma, Adam
Cornerstone courses of our academic heroically overcame his injuries so that he could return to Walter Reed for rehabilitation.
curriculum include American College of “You can never give up,” he says. “You have to believe.” Though dramatically different
Surgeons Advanced Trauma Life Support stories, both Adam and Kevin were able to recover from their injuries through the
(ATLS), and Society of Critical Care advanced care they received at Shock Trauma. They share the same inspiring outlook on
Medicine’s Fundamental Critical Care life as prime examples of what the Trauma Survivors Network strives for on a daily basis.
Support (FCCS). Surgical skills courses
are offered throughout the calendar year,
including Advanced Trauma Operative
Management (ATOM) and Advanced
Surgical Skills for Exposure in Trauma
(ASSET). Disaster Management and
Emergency Preparedness (DMAP) courses
are offered on a regular basis to all partners
in patient care, from first responders to
advanced clinicians.

2012 2013 2015
University of Maryland Shock Trauma Expansion of the Shock Trauma Center CareFirst Contributes $250,000 to Trauma and Critical
Center performed most extensive full to include 64 additional beds brings the Care Training Facility at The University Of Maryland R
face transplant in the world to date. total square footage to 240,000. Adams Cowley Shock Trauma Center.

6

Lynne Smith, RN (left) and
Stephanie Kennedy, MA, BSN, RN

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“We have a lot of very smart and dedicated
people here at Shock Trauma who really like
what they do. Together, we’ve created an
environment where we can constantly ask
questions, address problems, and implement
solutions to do what’s best for the patient.”
James V. O’Connor, MD, FACS, FCCP
Professor of Surgery
Chief of Critical Care
Chief of Thoracic Vascular Trauma

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Mary Ellen Dietrich, BSN, RN, CCRN; Rebecca Carter, PCT; Brooke Andersen, CRNP; Lewis Rubinson, MD, patients who need innovative therapies and
Ph.D., FCCP, Associate Professor, Department of Medicine, Program in Trauma, Director, Critical Care access to the latest clinical trials to manage
Resuscitation Unit; Angela Weir, RN their conditions. This customized unit also
serves as the clinical arm of the University
Shock Trauma’s Critical Care streamlined system moves the patient along of Maryland School of Medicine Program in
Resuscitation Unit (CCRU), was built on to the appropriate care area at the University Lung Healing for advanced pulmonary care
lessons learned from the Center’s Trauma of Maryland Medical Center (UMMC). and research.
Resuscitation Unit (TRU). The CCRU is the
first of its kind in the country, focused solely Ordinarily, patients suffering from respiratory The LRU’s multidisciplinary team of
on resuscitation and critical care for severely problems are placed on ventilators. professionals provides expert critical care
ill non-trauma adult patients referred by However, for some critically ill patients, even through an integrated process that taps
other hospitals. this step is not enough to maintain oxygen into best practices in Shock Trauma,
levels in their blood. It’s at this point that Pulmonology, Critical Care and Cardiac
Using data provided in advance by the Lung Rescue Unit (LRU) becomes Surgery. Patients with profound respiratory
referring clinicians and transport teams, a game-changer. The only unit of its kind failure usually require extracorporeal (outside
the CCRU team can put together an today, the LRU is designed specifically for the body) support in advance of a lung
innovative and customized response for transplant or in recovery from acute lung
the arriving patient, including necessary injury. An advanced technology called ECMO
subspecialist consultants. Once in the (extracorporeal membrane oxygenation)
CCRU, the patient’s immediate needs are delivers just that by removing carbon dioxide
addressed, starting with resuscitation and from the blood and circulating fresh oxygen
monitoring by an experienced interdisciplinary throughout the body, eliminating the need for
team of critical care-trained clinicians, nurses, patients to rely on their own failing lungs. This
and technicians. innovative procedure in using ECMO to treat
patients with advanced lung and heart failure
“Our entire job is admission,” notes Chief of has won UMMC national recognition as a
Critical Care Dr. James O’Connor. “We need Center of Excellence.
to get the patient stabilized and then evaluate
them to devise a plan of care. The CCRU 1,912
is uniquely designed to take care of very
sick people, no matter what problem they Critical Care
have.” Once that plan is determined, CCRU’s Resuscitation Unit
Admissions FY’15

Jay Menaker, MD, Associate Professor
of Surgery, Medical Director LRU,
Physician Director, Quality Management
and Theresa DiNardo, MSN, RN, CCRN,
Nurse Manager TRU, CCRU, LRU

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Deborah Stein, MD, MPH, FACS, FCCM
Professor of Surgery
Chief of Trauma
Medical Director Neurotrauma Center

10

Ask its Medical Director Deborah Stein, MD immediate access to portable x-ray machines.
what function the Trauma Resuscitation Unit “By the nature of its design, it’s also an ICU,”
(TRU) serves, and she’ll answer you quickly, says Dr. Stein, “so we can do everything from
“It is the gateway to Shock Trauma.” That’s no initial resuscitation to the most complicated
exaggeration; since its inception, this 24/7 unit bedside procedures and sophisticated critical
has been the first point of contact for critically management at any moment of the day,
injured patients entering the Shock Trauma without ever moving a patient.”
system. What’s more, the unit’s dedicated
team of trauma providers pride themselves on Shock Trauma maintains an advanced
always being available. resuscitative team, the GO-TEAM, led by
Medical Director Andrew Pollak, MD*, which
Accessible by a dedicated bank of elevators can respond to the actual scene where serious
from both the rooftop helipad and the injuries have occurred. The physician-led team
ambulance entrance, the TRU is adjacent to augments Maryland’s Statewide EMS System
the nine dedicated Shock Trauma Operating by providing critical care and surgical services
Rooms. The unit features 13 ICU-equipped beyond the scope of prehospital emergency
resuscitation bays, each with the capability care providers. When dispatched, the GO-
to resuscitate two patients simultaneously in TEAM consists of an attending physician
the event of a mass casualty incident. Also (anesthesiologist, surgeon, or emergency
onsite is an ultrasound unit that performs a medicine doctor) and/or a certified registered
Focused Abdominal Sonography for Trauma nurse anesthetist.
(FAST), a dedicated blood refrigerator, and

Brandon Ferebee, Stephanie Tarbell, BSN, RN, CCRN 11

*Andrew Pollak, MD; Chair, Department Of Orthopaedics; The James Lawrence Kernan Professor;
and Chair, Department of Orthopaedics; Chief of Orthopaedics

Karen Doyle, MBA, MS, RN, NEA-BC
Senior Vice President of Nursing & Operations
with Christopher Kuligowski, BSN, RN, and
Jennifer Miller, BSN, RN.

Sharon Asbury, RN
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Shock Trauma Nursing – A Continuing Culture of Collaboration

In 1961, an historic partnership was formed CRNAs to those countries. The STC team 2014 -2015 Highlights
when Elizabeth Scanlan, a clinical nurse, in Haiti remained onsite for six months.
joined Dr. R Adams Cowley in his small, In addition, when Brazil was chosen to STC’s Multi-Trauma Intermediate Care 6
two-bed unit at the University of Maryland. host the World Cup and Olympics, Shock (MTIMC6) team earned a silver-level Beacon
Together, they designed the system that Trauma assisted in training the medical staff Award for Excellence from the American
became the paradigm for today’s trauma for the events. Association of Critical-Care Nurses (AACN).
care. Cowley was the visionary, but Scanlan The Beacon Award is the most highly
made it happen, playing a pivotal role in STC Nursing also serves as the defining regarded national recognition for intensive
the establishment and development of the model for trauma nursing around the world, and intermediate care units, and MTIMC6 is
R Adams Cowley Shock Trauma Center, influencing the care of trauma patients the first Shock Trauma unit to be recognized
eventually becoming its first director and their families. “The contributions that with this award. Throughout Maryland, only
of nursing. our nurses make here are enormous and five other nursing units have been awarded
global,” says Doyle. “Our staff includes Beacon status.
This enduring spirit of collaboration important clinical researchers, textbook
continues today at Shock Trauma, where authors, and true leaders in areas of The American Nurses Credentialing Center
Dr. Thomas Scalea, Physician in Chief, clinical nursing practice.” As a case in (ANCC) re-designated the University of
and Karen Doyle, Senior Vice President of point, Karen McQuillan, RN, MS, CNS- Maryland Medical Center as a Magnet
Nursing & Operations jointly oversee the BC, CCRN, CNRN, FAAN, is currently the hospital for 2014-2018. Only 7 percent
center’s operations. Through their shared President of the American Association of hospitals nationwide currently hold this
commitment to the mission of Shock of Critical-Care Nurses (AACN) Board of designation. Magnet status recognizes
Trauma, they have created an elite team Directors. McQuillan also is a leading expert hospitals that sustain nursing excellence,
of intelligent, tenacious problem-solvers on neurotrauma nursing and co-author support evidence-based practice, and
who work as one every day to make the of Trauma Nursing: From Resuscitation demonstrate outstanding patient outcomes.
impossible possible. The uncommon Through Rehabilitation, a highly acclaimed
bond of loyalty, pride, and fellowship textbook used throughout the country. 10%
shared by physicians, nurses, technicians,
and staff underscores the central concept Along with research and collaborative Advanced Practice
here at Shock Trauma—that everyone international initiatives, STC Nursing also Nurses: CRNA, CRNP,
collectively matters in the shared goal of oversees a significant training program
patient survival. for visiting nurses. Over 35 nurses from and CNS.
four countries participated in STC’s formal
Through leadership, innovation and observation program in 2014 and 2015. 478
education, Shock Trauma Nursing Thanks to a close relationship with the
continues to set the global standard for University of Maryland School of Nursing, NURSES
clinical excellence, exemplified by our STC nurses are encouraged to advance
compassionate care for our patients and their practice in a number of advanced 20%
their families. specializations, including nurse practitioners,
clinical nurse specialists, and certified Have additional certifications
This focus on delivering exceptional nursing registered nurse anesthetists. Through in areas such as critical care,
care extends far beyond the walls of Shock this dynamic environment, what Doyle neurosciences, emergency,
Trauma itself. Following earthquakes in calls the “mother ship of trauma nursing”
China and Haiti, Scalea and Doyle quickly Shock Trauma continues to lead in ambulatory or OR.
deployed trauma response teams that nursing excellence.
included physicians, nurses, NPs, PAs and

13

Local research...

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As the leading center of its kind in totaling close to $7 million that focus on Dr. Megan Brenner is currently one of
the country, Shock Trauma has a traumatic brain injury and optimizing the the leaders in the development of a new
responsibility to move our field forward in safety of blood products for bleeding trauma potentially lifesaving technique—the
terms of discovery in trauma treatment. patients and 15 Department of Defense Resuscitative Endovascular Balloon
The best clinical care must remain in grants from the Air Force and Army which Occlusion of the Aorta (REBOA). REBOA
constant conversation with its research exceed $9 million. involves the placement of a small
counterpart in order for important endovascular (within a blood vessel) balloon
advances to be made. In this regard, the STC investigators: in the aorta as a means of minimizing
Center’s research efforts have never been hemorrhagic shock, the leading cause
stronger, more diverse or more promising. Dr. Deborah Stein, a trauma surgeon of death for those with traumatic injuries.
and intensivist, is engaged in clinical Dr. Brenner is trained in both trauma and
Founded in 2008, the Shock Trauma and research involving post-traumatic brain and vascular surgery. She has a clinical study
Anesthesiology Research Organized spinal cord injuries as well as hemorrhagic on the use of the REBOA funded by the
Research Center (STAR-ORC) is a shock. One of her Air Force funded studies Department of Defense.
world-class, multidisciplinary research is seeking biomarkers in the blood of a
and educational center focusing on brain brain-injured person that would indicate Rosemary Kozar, MD, PhD
injuries, critical care and organ support, whether they are at risk for neurologic Professor, Department of Surgery, Program in
resuscitation, surgical outcomes, patient deterioration. Trauma; Director of Translational Research
safety, and injury prevention. The US Air
Force is currently a major sponsor of Dr. Neeraj Badjatia is a Study Site Leader Dr. Rosemary Kozar’s current research,
research at STAR-ORC with 15 projects for the collaborative Transforming Research funded by the NIH, focuses on under-
funded for over $9.4 million. Clinical and Clinical Knowledge in Traumatic standing the molecular mechanisms by
projects under the direction of Drs. Hu and Brain Injury (TRACK-TBI) study that seeks which patient resuscitation with blood
Mackenzie include a study of continuous to create a massive shared database products, particularly plasma, protects
noninvasive monitoring, the development “commons” on traumatic brain injury to the endothelium (the cells lining our blood
of predictive triage indices for outcome accelerate research efforts. Dr. Badjatia is a vessels) to improve outcomes following
following trauma, and predicting blood neurologist with an interest in brain injuries major blood loss from trauma. Dr. Kozar is
product needs via prehospital vital signs. after trauma. a surgeon and intensivist who also has an
With funding from the US Air Force, Center interest in clinical and laboratory research in
researchers are also exploring the potential Dr. Samuel Tisherman’s new nutrition in the critically ill and injured.
development of a smart patient care system, investigation—Emergency Preservation
which takes the form of a sticky bandage and Resuscitation for Cardiac Arrest from Dr. Sarah Murthi, a surgeon and intensivist,
on a patient’s forehead that’s in fact a smart Trauma (EPR-CAT)—slated to begin soon has pioneered work in the use of the
pulse oximeter measuring blood oxygen will seek to save the lives of patients FREE (Focused Rapid Echocardiographic
levels. With the development of software who suffer cardiac arrest due to massive
that can capture and read the continuous bleeding. By administering a large amount
streaming data from critical care patients, of cold fluid to cool patients to around
physicians could make informed judgments 50°F., EPR may preserve the body’s organs
in real time to direct therapy. (specifically the brain and heart) during
cardiac arrest and buy time for surgeons
STAR-ORC also has both basic and clinical to find and stop the bleeding. The study
studies funded by the National Institutes is funded by the Department of Defense.
of Health (NIH) and the Department of Dr. Tisherman’s clinical expertise is in critical
Defense. There are 17 grants from the NIH care of the surgical patient.

15

Evaluation) exam in the care of injured Dr. Alan Faden is the principal investigator Sharing the Knowledge
patients in the ICU. She teaches the use in the Laboratory for the Study of Central
of cardiac ultrasound (such as the FREE Nervous System Injury. The lab uses 2014-2015 Publications
exam) to surgeons and trainees and has a multidisciplinary approaches—including
DOD (Department of Defense)-funded study molecular and cellular biology, animal 1. Adelgais KM, Kuppermann N, Kooistra J, Garcia
on novel biomarkers of volume status and modeling, behavior, imaging and drug M, Monroe DJ, Mahajan P, Menaker J, Ehrlich P,
cardiac function in traumatic shock. discovery—to examine the pathobiology of Atabaki S, Page K, Kwok M, Holmes JF. Accuracy
experimental brain and spinal cord injury of the Abdominal Examination for Identifying
Dr. Sam Galvagno is an anesthesiologist and their treatment. Specific research focus Children with Blunt Intra-Abdominal Injuries. J
in STAR. His research goal is to coordinate, areas include mechanisms of cell death, Pediatr. 2014;165:1230-1235.
develop, and lead efforts to expand the neuroinflammation, hypobaria, neuropathic
science of aeromedical critical care. His pain, brain-gut interactions, development 2. Afshar M, Smith GS, Terrin ML, Barrett M,
research interests center on the benefits of of biomarkers and drug discovery. The lab Lissauer ME, Mansoor S, Jeudy J, Netzer G.
helicopter emergency medical services and includes 7 faculty-level investigators, 6 post- Blood alcohol content, injury severity, and adult
critical care air transport for adults with major doctoral fellows, 4 technicians, and multiple respiratory distress syndrome. J Trauma Acute
trauma. Dr. Galvagno is currently funded by students. In FY 2016, it will be funded by 14 Care Surg. 2014 Jun;76(6):1447-55.
the Department of Defense for a prospective grants (including 9 NIH and 2 DOD).
study examining the role of prehospital point 3. Alton TB, Harnden E, Hagen J, Firoozabadi
of care testing for the early detection of Additional Programs in STAR-ORC: R. Single provider reduction and splinting of
shock, prediction of lifesaving interventions, displaced ankle fractures: a modification of
and determination of clinical course for The Crash Injury Research and Quigley’s classic technique. J Orthop Trauma.
patients with severe traumatic injuries. Engineering Network (CIREN) focuses on 2015 Apr;29(4):e166-71.
automotive safety and design based on
Dr. Gary Fiskum, a PhD investigator in in-depth engineering analysis of automotive 4. Anazodo AN, Murthi SB, Frank MK, Hu PF,
Anesthesia and the STAR-ORC, is funded crashes, serving as a test bed for emerging Hartsky L, Imle PC, Stephens CT, Menaker J,
by the NIH, the US Army and the Air Force. technologies. Epidemiologic research Miller C, Dinardo T, Pasley J, Mackenzie CF.
His lab focuses on neuroprotection following contributed by Shock Trauma investigators Assessing trauma care provider judgment in the
ischemic and traumatic brain injury. Their has included studies on lower extremity prediction of need for life-saving interventions.
preclinical research resulted in changes in injuries, predictors of mortality, and long- Injury. 2015 May;46(5):791-7.
clinical guidelines that now avoid the use of term outcomes, including PTSD following
excessive supplemental oxygen immediately injury, and injury and mortality trends by 5. Andrews PL, Sadowitz B, Kollisch-Singule M,
following brain injury. Other results indicate vehicle model year. Satalin J, Roy S, Snyder K, Gatto LA, Nieman GF,
that exposure to low pressure conditions Habashi NM. Alveolar instability (atelectrauma) is
associated with aeromedical evacuation The new Program on Aging, Trauma not identified by arterial oxygenation predispos-
within a few days after head trauma and Emergency Care (PATEC) seeks to ing the development of an occult ventilator-in-
worsens neurologic outcomes. They have serve as a national and international model duced lung injury. Intensive Care Med Exp. 2015
also described the mechanisms by which for clinical, basic, and population health Dec;3(1):54. doi: 10.1186/s40635-015-0054-1.
brain injury occurs to occupants of vehicles research in geriatric emergency and trauma Epub 2015 Jun 9. PubMed PMID: 26215818;
targeted by land mines and improvised care. Drawing from UMMC’s Center for PubMed Central PMCID: PMC4480795.
explosive devices, resulting in improved Research on Aging, the Department of
vehicle designs that mitigate injury to the Emergency Medicine, and Shock Trauma 6. Aungst SL, Kabadi SV, Thompson SM, Stoica
brain and other organs. Anesthesiology Research Center (STAR), BA, Faden AI. Repeated mild traumatic brain injury
PATEC collaborators include more than 40 causes chronic neuroinflammation, changes in
clinicians and researchers who are known hippocampal synaptic plasticity, and associated
internationally for their innovative work in cognitive deficits. J Cereb Blood Flow Metab.
aging, trauma, and emergency care. 2014 Jul;34(7):1223-32.

7. Badjatia N, Vespa P; Participants of the
International Multi-disciplinary Consensus
Conference on Multimodality Monitoring. Monitoring
nutrition and glucose in acute brain injury. Neurocrit
Care. 2014 Dec;21 Suppl 2:S159-67.

8. Ban K, Peng Z, Pati S, Witkov RB, Park PW,
Kozar RA. Plasma-mediated gut protection after
hemorrhagic shock is lessened in syndecan-1-/-
mice. Shock. 2015 Aug 10. [Epub ahead of print]

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Global impact

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L, Cheatham ML, Khansarinia S, Dayal S, Byers 2014 Feb;76(2):347-52. 2014;77:886-9.
PM, Diebel L. Multicenter review of diaphragm
pacing in spinal cord injury: Successful not only 111. Shalhub S, Starnes BW, Brenner ML, Biffl Nursing Publications
in weaning from ventilators but also in bridging WL, Azizzadeh A, Inaba K, Skiada D, Zarzaur
to independent respiration. J Trauma Acute Care B, Nawaf C, Eriksson EA, Fakhry SM, Paul JS, Carco, D. & Reece, M. (2014, March). Effects
Surg. 2014;76(2):303-10. Kaups KL, Ciesla DJ, Todd SR, Seamon MJ, of incentive program for trauma operating room
Capano-Wehrle LM, Jurkovich GJ, Kozar RA. efficiency, Poster Presentation at the AORN
102. Potter DR, Baimukanova G, Keating SM, Blunt abdominal aortic injury: A Western Trauma Surgical Conference and Expo, Chicago, IL.
Deng X, Chu JA, Gibb SL, Peng Z, Muench MO, Association multicenter study. J Trauma Acute
Fomin ME, Spinella PC, Kozar R, Pati S.Fresh Care Surg. 2014 Sep 22. [Epub ahead of print] Grissom, F., McQuillan, K. Collins, C., Kufera,
frozen plasma and spray-dried plasma mitigate J., Grafton, A., Von Rueden, K. (2014, May).
pulmonary vascular permeability and inflammation 112. Shrestha B, Holcomb JB, Camp EA, Del Evaluation of temperature intervention in patients
in hemorrhagic shock. J Trauma Acute Care Surg. Junco DJ, Cotton BA, Albarado R, Gill BS, Kozar at a trauma facility. American Association of
2015 Jun;78(6 Suppl 1):S7-S17. RA, Kao LS, McNutt MK, Moore LJ, Love JD, Critical Care Nurses- National Teaching Institute,
Tyson GH 3rd, Adams PR, Khan S, Wade CE. Denver, CO.
103. Rabin J, DuBose J, Sliker C, O’Connor JV, Damage-control resuscitation increases successful
Scalea T, Griffith BP. Parameters for Successful nonoperative management rates and survival after Rays, K. & Plummer, E. (2014). The use of post
Non-Operative Management of Traumatic Aortic severe blunt liver injury. J Trauma Acute Care Surg. arrest hypothermia in trauma resuscitation patients.
Injuries. J Thorac Cardiovasc Surg. 147(1): 143- 2015 Feb;78(2):336-41 Society of Trauma Nurse, New Orleans, LA.
150, 2014.
113. Steinhardt JJ, Peroutka RJ, Mazan- Scalea, T., Carco, D., Reece, M., Fouche, Y.,
104. Rabin J, Harris D, Crews G, Ho M, Taylor B, Mamczarz K, Chen Q, Houng S, Robles C, Barth Pollack, A., Nagarkatti, S. (2014). Effectos of a
Sarkar R, O’Connor JV, Scalea TM, Crawford RS. R, DuBose J, Bruns B, Tesoriero R, Stein D, Fang novel financial incentive program on operating
Early Aortic Repair Worsens Concurrent Traumatic R, Jones K, Hanna N, Pasley J, Rodriquez C, room efficiency. JAMA Surgery. 149(9), 920-924.
Brain Injury. Ann Thorac Surg. 98 (1): 46-52, 2014. Kligman D, Bradley M, Rabin J, Shackelford S,
Dai B, Landon AL, Scalea T, Livak F, Gartenhaus Patent Abstracts
105. Reynolds HN, Bander JJ. Options for tele- RB. Inhibiting CARD11 translation during BCR
intensive care unit design: centralized versus activation by targeting the eIF4A RNA helicase. Holcomb JB, Fox EE, Scalea TM, Napolitano LM,
decentralized and other considerations: it is not Blood. 2014 Dec 11;124(25):3758-67. Albarado R, et al. Current opinion on catheter-
just a “another black sedan”. Crit Care Clin. 2015 based hemorrhage control in trauma patients.
Apr;31(2):335-50. 114. Wade CE, Kozar RA, Dyer CB, Bulger EM, J Trauma Acute Care Surg. 76:888,893, 2014.
Mourtzakis M, Heyland DK. Evaluation of Nutrition
106. Rubinson L. From Clinician to Suspect Case: Deficits in Adult and Elderly Trauma Patients. JPEN Brenner M, Hoehn M, Pasley J, DuBose J, Stein
My Experience After a Needle Stick in an Ebola J Parenter Enteral Nutr. 2014 Feb 21. [Epub ahead D, Scalea T. Basic endovascular skills for trauma
Treatment Unit in Sierra Leone. The American of print] course: Bridging the gap between endovascular
Journal of Tropical Medicine and Hygiene. 2014; techniques and the acute care surgeon. The
92: 225-226. 115. Weltz AS, Harris DG, O’Neill NA, O’Meara Journal of Trauma and Acute Care Surgery.
LB, Brenner ML, Diaz JJ. The use of resuscitative 77:286-291, 2014.
107. Saksobhavivat N, Shanmuganathan K, Chen endovascular balloon occlusion of the aorta to
HH, DuBose JJ, Richard H, Khan MA, Menaker J, control hemorrhagic shock during video-assisted Brenner M, Hoehn M, Stein DM, Rasmussen TE,
Mirvis SE, Scalea TM. Blunt splenic injury: Use of a retroperitoneal debridement or infected necrotizing Scalea, TM. Central pressurized cadaver model
multidector CT-based splenic injury grading system pancreatitis. Int J Surg Case Rep. 2015 May (CPCM) for resuscitative endovascular balloon
and clinical parameters for triage of patients at 30;13:15-18. occlusion of the aorta training and device testing.
admission. Radiology. 2015;274:702-11 J Trauma Acute Care Surgery. 78:197-200, 2015.
116. Wisner DH, Kuppermann N, Cooper A,
108. Scalea J, Scuri S, Danquah J, Sarkar R, Menaker J, Ehrlich P, Kooistra J, Mahajan P, DuBose JJ, Savage SA, Fabian TC, Menaker
O’Connor JV, Crawford R, Scalea TM. Below The Lee L, Cook LJ, Yen K, Lillis K, Holmes JF. J, Scalea T, Holcomb JB, Skarupa D, Poulin N,
Knee Arterial Injury (BKAI): The Type of Vessel May Management of children with solid organ injuries Chourliaras K, Inaba K, Rasmussen TE and the
be More Important than the Number of Vessels after blunt torso trauma. J Trauma Acute Care AAST PROOVIT Study Group. The American
Injured. J Trauma and Acute Care Surg. 77:920- Surg. 2015;79:206-14. Association for the Surgery of Trauma Prospective
925, 2014. Observational vascular injury treatment (PROOVIT)
117. Zarzaur BL, Kozar R, Myers JG, Claridge registry: Multicenter data on modern vascular
109. Schmoekle NH, O’Connor JV, Scalea TS. JA, Scalea TM, Neideen TA, Maung AA, Alacon injury diagnosis, management, and out comes.
Non-operative Damage Control: The use of ECMO L, Corcos A, Kerwin A, Coimbra R. The splenic J Trauma Acute Care Surg. 78(2);215-223, 2015.
in Traumatic Bronchial Avulsion as a Bridge to injury outcomes trial: An American Association for
Definitive Operation. Ann Thor Surg. In press the Surgery of Trauma multi-institutional study. J DuBose JJ, Leake SS, Brenner M, Pasley J,
Trauma Acute Care Surg. 2015 Sept; 79(3):335-42. O’Callaghan T, Luo-Owen X, Trust MD, Mooney
110. Shackford SR, Kahl JE, Calvo RY, Kozar RA, J, Zhao FZ, Azizzadeh A, and the Aortic Trauma
Haugen CE, Kaups KL, Willey M, Tibbs BM, Mutto 118. Zielinski MD1, Jenkins D, Cotton BA, Inaba Foundation. Contemporary management and
SM, Rizzo AG, Lormel CS, Shackford MC, Burlew K, Vercruysse G, Coimbra R, Brown CV, Alley DE, outcomes of blunt thoracic aortic injury: A
CC, Moore EE, Cogbill TH, Kallies KJ, Haan JM, DuBose J, Scalea TM; AAST Open Abdomen multicenter retrospective study. J Trauma Acute
Ward J. Gunshot wounds and blast injuries to the Study Group. Adult respiratory distress syndrome Care Surgery. 78;(2);360-369, 2015.
face are associated with significant morbidity and risk factors for injured patients undergoing

22

Major Grant Awards Received in FY’15*

Transforming Research and Clinical Knowledge Feasibility of a Novel Opto-Acoustic Device to Modifying the Impact of ICU-Induced
in Traumatic Brain Injury II (TRACK-TBI II) Precisely Localize Endotracheal Tube Positioning Neurological Dysfunction (MIND-USA Study)
University of California, San Francisco/NIH in a Cadaver Model Vanderbilt University/NIH
09/01/2014 – 08/31/2015 Air Force of Scientific Research 03/15/2011 -02/29/2016
$252,268 – Badjatia, N. 09/05/2014 – 12/04/2015 $126,157 – Rock, P.
$55,178 – Galvagno, S.
Log No. 13057166, Clinical Study of Long-term Impact of Natural Disasters on
Resuscitative Endovascular Balloon Occlusion Mechanisms of Recovery Following Disability and Health in Older Americans
of the Aorta (REBOA) for Severe Pelvic Fracture Traumatic Brain Injury University of Michigan Ann Arbor/NIH
and Intra-abdominal Hemorrhagic Shock using University of Miami/NIH 09/30/2013 – 06/30/2015
Continuous Vital Signs 09/01/2010 – 07/31/2015 $25,413 – Rubinson, L.
Department of Defense $790,958 – Hu, B.
02/02/2015 – 02/29/2016 EP Vent 2-A Phase II Trial Esophageal
$1,000,000 – Brenner, M. Development and Validation of Prototype Pressure Guided Ventilation
Continuous-Real Time Vital Signs Monitoring University of Michigan Ann Arbor/NIH
MHSO Field Staff Program Coordination System “CCATT Viewer” 07/01/2014 – 06/30/2015
NHTSA/Motor Vehicle Administration/State Air Force of Scientific Research $37,495 – Rubinson, L.
Government 09/23/2014 – 09/22/2015
10/01/2014 – 09/30/2015 $226,179 – Hu, P. EP Vent 2-A Phase II Trial Esophageal
$1,099,769 – Dischinger, P. Pressure Guided Ventilation
Function and Mechanisms of Autophagy- Beth Israel Deaconess Medical Center/National
MD Center for Traffic Safety & Analysis (MCTSA) Lysosomal Pathway in Traumatic Brain Injury Heart, Lung, and Blood Institute
NHTSA/Motor Vehicle Administration/State National Institute of Neurological 07/01/2014 – 06/30/2015
Government Disorders & Strokes $37,495 – Rubinson, L.
10/01/2014 – 09/30/2015 03/01/2015 – 08/28/2016
$489,959 – Dischinger, P. $1,675,546 – Lipinski, M. Advancing Regulatory Science and Innovation:
Facilitating Development of Medical Counter
MHSO Staffing Program Coordination The PARK10 gene USP24 affects Parkinson’s Measures to Protect Against Threats
NHTSA/Motor Vehicle Administration/State Disease via regulation of autophagy Harvard University/NIH
Government NIH 09/15/2014 – 09/14/2015
10/01/2014 – 09/30/2015 09/30/2014 – 08/31/2016 $49,091 – Rubinson, L.
$1,316,063 – Dischinger, P. $153,500 – Lipinski, M
Crash Injury Research and Engineering Network
Role of Cell Cycle Pathways in Traumatic Microglial activation phenotypes and (CIREN)
Brain Injury (TBI) mechanisms of repair in the aged TBI brain NHTSA
NINDS NINDS 06/01/2010 – 05/31/2016
05/12-01/17 09/28/2013 -07/31/2017 $2,600,000 – Scalea, T.
$897,519 – Faden, A. $1,355,328 – Loane, D
PROPPR
Spinal Mechanisms Underlying SCI-Induced PT110675 Underbody Blast Models of TBI University of Texas Health Science Center/NIH
Pain; Implications for Targeted Therapy Caused by Hyper-Acceleration and Secondary 01/01/2015 – 09/30/2015
NINR Head Impact $51,632 – Scalea, T.
03/12-02/17 Department of Defense
$1,624,449 – Faden, A. 02/15/2013 – 02/14/2016 Hangovers and Traffic Injuries: Is Alcohol’s
$1,984,190 – Mackenzie, C. Influence Greater Than Expected?
Center for the Genomics of Pain National Institute on Alcohol Abuse and Alcoholism
NINR Novel Measures of Volume Status and 05/01/2010 – 04/30/2016
09/12-06/17 Cardiac Function in Traumatic Shock $2,719,001 – Smith, G.
$123,521 – Faden, A. Air Force of Scientific Research
07/02/2013 – 07/01/2015 Alcohol Involvement in a Cohort of Trauma
Prolongation of Platelet Storage Time by $752,211 – Murthi, S. Patients: Trends and Future Mortality
Protection against Mitochondrial Energy Failure National Institute on Alcohol Abuse and Alcoholism
Air Force of Scientific Research Novel Mechanisms of Microglial Neurotoxicity 04/10/2010 – 03/31/2016
07/01/2014 – 05/31/2015 at Physiological Oxygen $1,453,027 – Smith, G.
$276,789 – Fiskum, G. NINDS
09/30/2013 - 07/31/2018 Cell Cycle Pathway Inhibition Decreases
PT110675 Underbody Blast Models of TBI $1,675,546 – Polster, B. Peripheral Neuropathic Pain
Caused by Hyper-Acceleration and Secondary National Institute of Nursing Research
Head Impact Perioperative Cognitive Protection- 05/10/2013 – 04/30/2015
Department of Defense Dexmedetomidine and Cognitive Reserve, $161,970 – Wu, Junfang
06/06/2014 – 06/05/2014 “Dexlirium Trial”
$1,529,653 – Fiskum, G. Mount Sinai/NIH
07/01/2009 -06/30/2015
*01Jul14 –30Jun15 $33,712 – Rock, P.

231

Making a World of Difference

Global Outreach: Trauma Observation Program
Providing Educational Opportunities to Health Care Providers in 47 Countries and Counting*

Europe Primary Observation Service
Denmark 2
North America England 5 Administration 7 Nursing 20
Canada 6 Greece 1 Anesthesia 8 Orthopaedics 17
United States 65 Italy Critical Care 4 Plastic Surgery 7
Scotland 1 Neurosurgery 1 Trauma Team 71
Spain 3
Sweden 1

South America Africa Mid-East Asia
Argentina 2 Egypt 1 Israel 5 China 9
Brazil 1 Ethiopia 1 Jordan 1 India 5
Chile 5 South Africa 1 Pakistan 3 Japan 3
Columbia 1 Qatar 2 Korea 2
Saudi Arabia 2 Nepal 5
*July 2014 – June 2015
Total Observers
FY’15: 137 Observers

Given Shock Trauma’s long history Closer to home, our Trauma Observation EMS Outreach
of discovery and innovation, it’s not Program (TOP) at Shock Trauma offers Shock Trauma’s EMS Office maintains
surprising that current conversations with health care professionals the opportunity an active prehospital outreach program
other health care providers reach across to expand their knowledge and skills by for providers, including both in-hospital
the globe. Our staff regularly presents interacting closely with our world-renowned and out-of-hospital training. Through this
new discoveries at regional, national, leaders in trauma and critical care medicine. program, first responders can gain a better
and international professional meetings By attending clinical discussions, meetings understanding of the relationship between
and publishes in peer-reviewed journals and lectures, rounds, and observations of prehospital procedures and definitive
and books. In addition, our professionals operational procedures at TOP, participants treatment in the hospital. Providers also can
frequently are invited to consult on the gain a greater range of understanding in choose to accompany a trauma nurse for
development or improvement of trauma regards to trauma and trauma systems as eight hours in two different clinical settings:
centers and systems in the US and well as their particular area of interest. the Trauma Resuscitation Unit or the Critical
around the world including Haiti, China, Care Unit.
India, Italy, Qatar, and Brazil.

24

In collaboration with the Anesthesiology Dr. Deborah Stein, Associate Professor of Dr. Samuel Tisherman, Professor of
Department, Maryland State Police Aviation Surgery and Chief of Trauma, has a role on Surgery; Director of the Center for Critical
Command, and EMS educators from the Ad Hoc Acute Care Surgery Committee Care and Trauma Education; and Director
across the state, the EMS Office of the for the Eastern Association for the Surgery of the Surgical ICU has been appointed to
Shock Trauma Center also offers an of Trauma (EAST) and the Ad Hoc Geriatric the Trauma, Burns and Critical Care Board
all-day Advanced Life Support (ALS) airway Trauma Committee for AAST. of the American Board of Surgery. He was
training program with Rapid Sequence also elected President-elect of the Surgical
Intubation training. Dr. William Chiu, Associate Professor of Critical Care Program Directors’ Society.
Surgery; Program Director Surgical Critical
The EMS Office provides ongoing Care Fellowship; and Chair, Shock Trauma Karen Doyle, MBA, MS, RN, NEA-BC, Vice
educational opportunities for prehospital Center Research Committee, is a member President of Nursing & Operations at the
providers. During 2014, evening educational of the Board of Directors for EAST as well R Adams Cowley Shock Trauma Center,
programs open to prehospital and hospital as Chairman for the Careers in Trauma completed her year as the President for the
care providers were offered ten times and Committee and Ex Officio for the Program Society of Trauma Nurses (STN) and is a
could be streamed live to 24 remote sites Committee. He was elected Treasurer of the member of the State Emergency Medical
across Maryland. Surgical Critical Care Program Directors’ Services Advisory Council.
Society.
Leading by Reputation Karen McQuillan, MS, RN, CSN-BC,
Over the past year, a number of University Dr. Jose Diaz, Professor of Surgery and CCRN, CNRN, FAAN, serves on the
of Maryland School of Medicine faculty and Chief of Acute Care Surgery, is on the American Association of Critical Care
Shock Trauma staff have joined or assumed Ad Hoc Acute Care Surgery Committee Nurses (AACN) Board of Directors and
leadership positions in important national, for EAST. is the President of the organization. She
regional, and state organizations. also serves on the AACN Certification
Dr. Raymond Fang, Director, US Air Force Corporation.
Dr. Thomas Scalea recently completed Center for Sustainment of Trauma and
his term as President of the American Readiness Skills (C-STARS), is the Vice- Tara Reed Carlson, MS, RN, is the Chair
Association for the Surgery of Trauma Chair of the Military Liaison Committee for the Maryland Trauma Center’s Network
(AAST), and continues as President of the for EAST. (TraumaNet), holds a board position on
Western Society of Trauma (WST). He holds the Partnership for a Safer Maryland
positions on the Membership Committee, Dr. Andrew Pollak, Chair, Department of and is the Injury Prevention Chair for the
Program Committee, Scholarship and Orthopaedics; Professor of Orthopaedics; Trauma Centers Association of America.
Awards Committee, International Relations Chief, Division of Orthopaedic Traumatology; She also received Nurse.com’s 2015
Committee and the Nominating Committee, Associate Director of Trauma at the R Nursing Excellence GEM (Giving Excellence
and is a member of the Board of Managers Adams Cowley Shock Trauma Center; Meaning) Award in Home, Community and
of the AAST. and Program Director, Orthopaedic Ambulatory Care for the DC/Maryland/
Traumatology Fellowship, is the Past Virginia region.
President of the Orthopaedic Trauma
Association.

Dr. Robert O’Toole, Professor of
Orthopaedics and Chair, Department of
Trauma Orthopaedics, is the Co-Chair of
the Program Committee for the Orthopaedic
Trauma Association.

25

Injury Prevention – A Major Part of Our Mission

“At Shock Trauma, our best patients are
the ones we never see. If we can prevent
a critical injury from taking place, it’s a
huge win for that family, their community
and us.” - Tara Reed Carlson, MS, RN

Center for Injury Prevention & Policy Events Attendees
12,425
Prevention Outreach 59 280
656
Trauma Prevention Program: Teens 28 3,655
2,584
Trauma Prevention Program: Adults 12 185
19,785
Trauma Survivors Network 1,112

Violence Prevention Programs 695

Minds of the Future 10

Total FY’15 1,916

At Shock Trauma, we believe that preventing Tara Reed Carlson, MS, RN, Business Development Manager, R Adams Cowley Shock Trauma Center
a critical injury is as important as healing and Mayur Narayan, MD, MPH, MBA, FACS, FICS, Assistant Professor, Department of Surgery
one. To fulfill this part of our mission, the Director, Center for Injury Prevention & Policy
Center for Injury Prevention and Policy
(CIPP) coordinates and directs a dynamic this age group to make good decisions Carnell Cooper, MD, FACS
range of community outreach initiatives and before they place themselves in dangerous Clinical Associate Professor of Surgery
educational programs informed by research situations, the program works to create a Director of Trauma Prince George’s Hospital Center
and injury trends. more informed adult population for the future. Sr. VP and Chief Medical Officer Dimensions Health
VP Medical Affairs Prince George’s Hospital Center
Founded in 2011 by its current directors, The CIPP team has impacted policy with
Mayur Narayan, MD, MPH, MBA, FACS and a strong presence during the Maryland The Bridge Project, a domestic/intimate
Tara Reed Carlson, MS, RN, CIPP seeks legislative session. They have provided oral partner violence program began in 2014, to
to create a culture of prevention among and written testimony on injury prevention provide services and resources to victims of
various at-risk groups through educational related-legislation. Its Trauma Prevention intimate partner violence. Since its inception,
workshops, on-site school presentations, Program visits Maryland high schools the Bridge project has assisted 85 clients
and other innovative programming. To throughout the year to focus on smart through a variety of services.
date, CIPP has staged hundreds of events decision-making while driving.
throughout Maryland, reaching 20,000 For more information on our programs,
residents each year with its compelling The Violence Prevention Program visit umm.edu/programs/shock-trauma/
message of prevention. In addition, through (VPP), started by Dr. Carnell Cooper, MD, services/injury-prevention.
collaboration with the Maryland Motor FACS in 1998, continues to reach victims
Vehicle Administration, 50,000 driver’s of interpersonal violence with an array of
education participants annually watch CIPP’s resources. The VPP is an intensive hospital-
presentations on impaired and distracted based intervention program that assists
driving as a part of their required training. victims of intentional violent injury, including
gunshots, stabbings, and beatings. Victims
Because children and teens can be most receive assessment, counseling, and social
vulnerable to preventable injury, CIPP orients support from a multi-disciplinary team to help
many of its programs to them. By teaching make critical changes in their lives.

26

Trauma Center Facts

10000 Patient Volumes 96% 65%

Survival Rate Male

8000 8,355 8,628 8,265 79% 40%
6000
7,930 7,628 Arrived by Patient Age 15-35
ground Stats
28%
4000 21%
Age 36-55
Arrived
by air

2000 32%

Ages 56+

0 15%

FY11 FY12 FY13 FY14 FY15 Other

18% Mechanism 36%
of Injury
Violence MVC/Traffic
Related

Admission trends show a decrease in automobile-related trauma 31%
as older cars are being replaced with newer, more safety-
conscious models. In contrast, admissions related to falls have Falls
increased due to the aging population. In 2015 alone, STC
admitted 11 patients who were over 100 years old.

The R Adams Cowley Shock Trauma Center serves as
the State’s Primary Adult Resource Center (PARC).

The STAPA Practice Plan provides professional billing and collections services for
physicians employed by the University of Maryland School of Medicine, including those
in Shock Trauma.

“Through rigorous screening of our Under the UMMS Medical Service Plan, in addition to clinical instruction for medical
own clinical hires and by enforcing students and other trainees, faculty members provide healthcare and emergency
continuous quality improvement across physician services to the general public, and without charge to the indigent population
all of our management practices, STAPA on behalf of the School of Medicine.
has created a model for medical and
business excellence in our practice plan The STAPA staff of over 160 faculty and staff members, also handles all HR, Finance
that other hospitals can emulate.” and Research oversight in relation to the Practice Plan. Despite challenging economic
times and pressures on reimbursement, the Program exceeded financial targets and
Chris Ennis, MS, Senior Administrator, benchmarks for the Fiscal Year. In FY’15, charges and collections exceeded the prior
Shock Trauma Associates, PA year by approximately 30% each; at the same time, STAPA also exceeded the annual
budget for charges and collections by approximately 20% each. Close attention is
paid to billing and reimbursement and monitoring of expenses. For FY’15, STAPA’s
Operating Margin was approximately 9%.

27

Your Support – It Gives Us Life

The Shock Trauma Center is a non- Tribute Gifts Endowed Professorships
profit organization. We receive minimal Shock Trauma tribute gifts provide a
state funding and depend directly upon meaningful way to acknowledge occasions Endowed Professorships provide our
philanthropic partnerships and donors of sympathy, celebration or gratitude, either Center with the resources necessary
like you to maintain our momentum in as a memorial gift or a living tribute. to attract and retain current and
providing world-class trauma care. future leaders in Trauma and Critical
Matching Gifts Care. These endowments also
This need is especially acute in meeting the If your employer or other affiliated prove invaluable when recruiting well
current goal of our Shock Trauma Critical organization has a matching gift program, established and highly sought experts
Care Tower Campaign. Of the $35 million you can sometimes double or even triple to join our team.
goal, $10 million is designated to support the your philanthropic gift.
newly established Center for Critical Care and Francis X. Kelly Chair in Trauma
Trauma Education. To date, more than $18 Planned Giving Surgery: Support, in perpetuity, a Chair
million has been contributed by generous You can support Shock Trauma by planning in Trauma Surgery at the University of
individuals, foundations, and corporations. a gift through your will, trust, charitable Maryland School of Medicine
Your gift to the campaign may be designated gift annuity, life insurance, retirement plan
to the program area of your choosing and will or other planned giving options. Each David S. Brown Professorship in
make all the difference in assuring our future type of planned gift offers a distinct set Trauma: Provides endowed support
as a leader in trauma medicine. of advantages. A representative from the for a professorship in the Program in
University of Maryland Medical System Trauma to a faculty member and expert
Life Partners Foundation can discuss options with you in the National Study Center for Trauma
and work together with your financial and Emergency Medical Systems
Shock Trauma’s Life Partners program advisor to ensure your goals are met. Please
significantly impacts our ability to expand call 410-328-5770 for more information. Anne Scalea Professorship in Trauma:
and sustain our mission to provide Provides support for a professorship in
unparalleled, lifesaving care. By joining Giving Online the Program in Trauma at the University
the program, you will become part of an www.ummsfoundation.org/stc is a secure of Maryland School of Medicine
exclusive membership who believes deeply and easy way to make a gift. Contributions
in the greater mission of the R Adams can be made using your credit or debit card. R Adams Cowley, MD Professorship
Cowley Shock Trauma Center and its Please designate your gift as in support of in Trauma: Provides endowed support
continued leadership in providing lifesaving the Shock Trauma Center Area of Greatest for a professorship in the Program
critical care. Need or the program of your choosing. in Trauma

As a Life Partner, you will commit to recurring Paul N. Manson, MD Distinguished
monthly donations that directly support Professorship in Plastic &
Shock Trauma. In return, you will be honored Reconstructive Surgery: Provides
and recognized on our website, while your support for a distinguished
name will be displayed in the Shock Trauma professorship at the University of
Critical Care Tower. More importantly, you will Maryland School of Medicine
directly help to advance our mission and the
lifesaving work we do. To learn more, visit Hamish S. & Christine C. Osborne
www.ummsfoundation.org/stc. Professorship in Advanced
Pulmonary Care: Provides endowed
support for a professorship in Advanced
Pulmonary Care at the University of
Maryland School of Medicine

28

“Shock Trauma has been part of my life since
1978. How many people are able to say that
they’ve made a contribution to the finest system
of its kind in the world? It’s a privilege to do so.”

The Honorable (Senator) Francis X. Kelly, Jr.
Chairman of the Shock Trauma Center Board of Visitors

The Shock Trauma Center is
a multidisciplinary clinical,
educational, and research
institution dedicated to
world-class standards in the
prevention and management
of critical injury and illness.

Nobody does it better.

Why Pink Scrubs?

Pink became the signature color for all of the
Shock Trauma clinical staff when, back in the
early days of the Center, Dr. Cowley chose it
from the available scrub colors of pink, green
and blue. He found it unique and, as a rather
unpopular color, the least likely to be taken
from the hospital and require expensive
replacement. Today, the Shock Trauma staff
proudly wears pink scrubs as a source of
pride, indicating membership among a very
elite team of caregivers to the region’s most
critically ill and injured patients.

Mark Wieber, BSN, RN, CNOR