R Adams Cowley Shock Trauma Center (also referred to simply as Shock Trauma) is a free-standing
trauma
Trauma most often refers to:
* Major trauma, in physical medicine, severe physical injury caused by an external source
* Psychological trauma, a type of damage to the psyche that occurs as a result of a severely distressing event
*Traumatic i ...
hospital in
Baltimore
Baltimore ( , locally: or ) is the List of municipalities in Maryland, most populous city in the U.S. state of Maryland, fourth most populous city in the Mid-Atlantic (United States), Mid-Atlantic, and List of United States cities by popula ...
, Maryland and is part of the
University of Maryland Medical Center
The University of Maryland Medical Center (UMMC) is a teaching hospital with 806 beds based in Baltimore, Maryland, that provides the full range of health care to people throughout Maryland and the Mid-Atlantic region. It gets more than 26,000 inpa ...
. It was the first facility in the world to treat
shock
Shock may refer to:
Common uses Collective noun
*Shock, a historic commercial term for a group of 60, see English numerals#Special names
* Stook, or shock of grain, stacked sheaves
Healthcare
* Shock (circulatory), circulatory medical emergen ...
. Shock Trauma was founded by
R Adams Cowley
R Adams Cowley (July 25, 1917 – October 27, 1991) was an American surgeon considered a pioneer in emergency medicine and the treatment of Shock (circulatory), shock Physical trauma, trauma. Called the "Father of Trauma Medicine", he was the foun ...
, considered the father and major innovator of
trauma medicine
Trauma most often refers to:
*Major trauma, in physical medicine, severe physical injury caused by an external source
*Psychological trauma, a type of damage to the psyche that occurs as a result of a severely distressing event
*Traumatic inju ...
.
Early years
While serving in the
United States Army
The United States Army (USA) is the land service branch of the United States Armed Forces. It is one of the eight U.S. uniformed services, and is designated as the Army of the United States in the U.S. Constitution.Article II, section 2, cla ...
in France immediately following
World War II
World War II or the Second World War, often abbreviated as WWII or WW2, was a world war that lasted from 1939 to 1945. It involved the vast majority of the world's countries—including all of the great powers—forming two opposin ...
, Cowley observed that many severe traumatic injuries could be stabilized if the patient could be transported to a
military hospital
A military hospital is a hospital owned and operated by a military. They are often reserved for the use of military personnel and their dependents, but in some countries are made available to civilians as well. They may or may not be located on a ...
where a surgeon was present within one hour of the initial injury. Cowley coined the term "
golden hour" to describe this crucial period of time. Cowley thus lobbied the legislature in
Maryland
Maryland ( ) is a state in the Mid-Atlantic region of the United States. It shares borders with Virginia, West Virginia, and the District of Columbia to its south and west; Pennsylvania to its north; and Delaware and the Atlantic Ocean to ...
to purchase helicopters for the transport of trauma patients to expedite their arrival to these higher-care facilities. The Maryland legislature initially denied his request, due to the cost of helicopters, but he was subsequently able to persuade the State of
Maryland
Maryland ( ) is a state in the Mid-Atlantic region of the United States. It shares borders with Virginia, West Virginia, and the District of Columbia to its south and west; Pennsylvania to its north; and Delaware and the Atlantic Ocean to ...
to purchase helicopters by agreeing to the premise they be shared with the
Maryland State Police
The Maryland State Police (MSP), officially the Maryland Department of State Police (MDSP), is the official state police force of the U.S. state of Maryland. The Maryland State Police is headquartered at 1201 Reisterstown Road in the Pikesville ...
. Today, almost all major
trauma center
A trauma center (or trauma centre) is a hospital equipped and staffed to provide care for patients suffering from major trauma, major traumatic injuries such as Falling (accident), falls, motor vehicle collisions, or gunshot wounds. A trauma cent ...
s in the United States utilize helicopters to transport trauma patients to the hospital.
During the establishment of
trauma center
A trauma center (or trauma centre) is a hospital equipped and staffed to provide care for patients suffering from major trauma, major traumatic injuries such as Falling (accident), falls, motor vehicle collisions, or gunshot wounds. A trauma cent ...
s in the early 1970s, Cowley fought with the medical community to change the prevailing policy of first responders taking all patients, including traumas, to the "nearest hospital first." According to Cowley, the major flaw to this system was that the nearest hospital was most likely not capable of treating severe trauma. In 1975,
Dutch Ruppersberger
Charles Albert "Dutch" Ruppersberger III ( ; born January 31, 1946) is an American lawyer and politician serving as the U.S. representative for since 2003. A member of the Democratic Party, he previously served as an assistant state attorney of ...
, a young prosecutor (and current member of Congress) was involved in a nearly fatal automobile accident and had his life saved largely in part to being transported directly to University of Maryland's Shock Trauma Center. When Ruppersberger asked Cowley what he could do to repay him for saving his life, Cowley responded, "Run for office so you can help us get the resources we need to continue saving lives.” Ruppersberger successfully ran for numerous local, state, and federal elective offices all the while advocating for shock trauma. The policy of "nearest hospital first" was eventually abandoned, and emergency medical systems across the United States now follow the model first advocated by Cowley.
Facilities
Shock Trauma houses over 100 inpatient beds dedicated to
emergency surgery
Elective surgery or elective procedure (from the la, eligere, meaning to choose) is surgery that is scheduled in advance because it does not involve a medical emergency. Semi-elective surgery is a surgery that must be done to preserve the patie ...
,
resuscitation
Resuscitation is the process of correcting physiological disorders (such as lack of breathing or heartbeat) in an acutely ill patient. It is an important part of intensive care medicine, anesthesiology, trauma surgery and emergency medicine. W ...
, intensive care, and acute surgical care. The facility boasts a dedicated resuscitation area in excess of 13 beds. The Trauma Resuscitation Unit (TRU) is located on the building's second floor. Helicopters and ambulances bring injured patients directly to the TRU for emergency treatment and stabilization. Specialized trauma teams composed of
trauma
Trauma most often refers to:
* Major trauma, in physical medicine, severe physical injury caused by an external source
* Psychological trauma, a type of damage to the psyche that occurs as a result of a severely distressing event
*Traumatic i ...
surgeons and
emergency medicine
Emergency medicine is the medical speciality concerned with the care of illnesses or injuries requiring immediate medical attention. Emergency physicians (often called “ER doctors” in the United States) continuously learn to care for unsche ...
physicians triage and treat patients as they arrive by helicopter and ambulance. Teams of consultants are available 24/7 and include orthopedic surgeons, neurosurgeons, vascular surgeons, plastic and reconstructive surgeons, radiologists, anesthesiologists, and others. Shock Trauma is an academic institution and emergency-medicine residents, trauma fellows, and surgical residents are involved in all aspects of patient care and evaluation. A large team of trauma physician assistants, nurse practitioners, nurses, and technicians complete the trauma team personnel and stand ready to receive victims 24 hours a day, 365 days per year. The helipad at Shock Trauma can accommodate up to four
medevac
Medical evacuation, often shortened to medevac or medivac, is the timely and efficient movement and en route care provided by medical personnel to wounded being evacuated from a battlefield, to injured patients being evacuated from the scene of a ...
helicopters at one time and has direct elevator access to the resuscitation area several stories below.
Adjacent to the TRU is a vast array of equipment and facilities that are immediately available to the patient in extremis. Shock Trauma has nine dedicated operating suites, its own unique trauma post-anesthesia care unit, in addition to two dedicated
multislice CT scanners, an
angiography
Angiography or arteriography is a medical imaging technique used to visualize the inside, or lumen, of blood vessels and organs of the body, with particular interest in the arteries, veins, and the heart chambers. Modern angiography is performe ...
suite, and digital
plain film capability. The inpatient wards of the Shock Trauma center consist of specialized intensive-care units, intermediate-care units, and regular surgical-floor beds. Shock Trauma can admit patients directly into the operating room if their condition requires it. Intensive care at Shock Trauma is a multidisciplinary endeavor: the facility boasts dedicated units for victims of multi-system and neurosurgical trauma.
In 2013, Shock Trauma Center completed and opened a major expansion to the facility. Renovating around 68 patient rooms to conform with modern-day standards.
Education
Shock Trauma trains physicians and medical personnel from locations overseas and throughout the United States. In addition to training residents at the University of Maryland itself, the facility hosts emergency-medicine and surgery residents from all over the United States and Canada. Shock Trauma receives over 7500 admissions per year and provides its residents with intensive training in the evaluation and management of both blunt and penetrating injury.
In May 2007, Thomas M. Scalea, physician-in-chief for the R Adams Cowley Shock Trauma Center, presented a case at the University of Maryland Medical School's annual historical clinicopathological conference in Baltimore on the assassination of President
Abraham Lincoln
Abraham Lincoln ( ; February 12, 1809 – April 15, 1865) was an American lawyer, politician, and statesman who served as the 16th president of the United States from 1861 until his assassination in 1865. Lincoln led the nation thro ...
and whether the world's first center for trauma victims could have improved the outcome had Lincoln's assassination occurred today. "This could be a recoverable injury, with a reasonable expectation he would survive," Scalea said, noting that the assassin's weapon was relatively impotent compared to the firepower now on the streets today.
Shock Trauma's educational mission extends beyond the training of future physicians. The facility hosts members of the United States Armed Forces, in addition to providing education for local emergency-medical service providers.
Movie
In 1982, a television movie was produced by Telecom Entertainment and Glen Warren Productions about Cowley, his discovery of "The Golden Hour" and his crusade to establish the first fully dedicated trauma center in the world. The movie starred
William Conrad
William Conrad (born John William Cann Jr., September 27, 1920 – February 11, 1994) was an American actor, producer, and director whose entertainment career spanned five decades in radio, film, and television, peaking in popularity when he s ...
(of ''
Cannon
A cannon is a large- caliber gun classified as a type of artillery, which usually launches a projectile using explosive chemical propellant. Gunpowder ("black powder") was the primary propellant before the invention of smokeless powder ...
'' fame) as Cowley. It was syndicated on TV stations all across the United States on October 27, 1982.
Television
The television docudrama series ''Shock Trauma: Edge of Life'', which aired on Discovery Life was filmed at R Adams Cowley Shock Trauma Center.
References
External links
*
{{authority control
Hospital buildings completed in 1960
Hospitals in Baltimore
University of Maryland, Baltimore