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Vanderbilt University Medical Center Reporter

Rounds: A message from the Vice Chancellor

Posted on Thursday, Nov. 1, 2012 — 10:41 AM

(photo by Warne Riker)

Even though I’ve spent the majority of my career at Vanderbilt, I still look up when I hear the sound of LifeFlight approaching. And I still notice when injured patients are chronicled in newscasts nearly every night with the steady refrain “taken to Vanderbilt.”

Jeff Balser, M.D. Ph.D. vice chancellor for Health Affairs and dean of the School of Medicine

What I think about now is what lies “behind the curtain.” During some of my recent rounding sessions I have been visiting with the people who make it happen. Beyond expressing my deep appreciation for their skill, commitment and compassion, I’d like to share some facts that help put these extraordinary programs into perspective.

LifeFlight recently celebrated its 28th anniversary. Since its first flight on July 5, 1984, the program has safely logged more than 33,000 patient transports and now averages 220 transports each month to Vanderbilt and a vast array of other area hospitals. From these somewhat humble beginnings, LifeFlight now supports a highly sophisticated Regional Communications Center that handles emergency air traffic control for Middle Tennessee, receiving a phone call every 30 seconds. The program supports six helicopters, a long-range airplane with ICU-like capabilities that flies at 300 miles per hour, and specially equipped ground ambulances.

Like busy airports, our helipads at VUH and Monroe Carell Jr. Children’s Hospital average more than 10,000 arrivals and departures each year. And LifeFlight’s Event Medicine program provided emergency medical support for more than 500 events last year including the CMA Music Fest and the Nashville Predators games.

The people making this possible are truly extraordinary. LifeFlight‘s flying and rolling critical care units are staffed by some of the most highly trained nurses, paramedics, pilots and drivers in the health care industry. LifeFlight’s accomplished medical crews, each averaging 10 years of critical care nursing experience, routinely perform complex and risky procedures — such as the placement of chest tubes — in mid-flight. I marvel at the courage and skill necessary to save a life while bouncing around at 3,000 feet.

On the receiving end of these myriad emergency transports are a vast array of programs, from our Adult and Pediatric Emergency Departments to our Burn, Trauma, Surgical Critical Care and Pediatric Intensive Care Units. These programs are among the nation’s highest performing and busiest, treating more than 100,000 patients each year.

We are the definitive point of care for the most critically injured and acutely ill patients in the region, throughout Middle Tennessee and reaching into Alabama and Kentucky. Our faculty and staff not only provide the bedside care, but lead the key programs in our city and state that organize the way this care can be provided quickly and effectively for the region. For example, the Department of Emergency Medicine faculty serve as medical directors for the Metro Nashville Emergency Medical System.

Highly specialized care delivered at institutions like ours is making a difference. Recent advances in the care of trauma and burn patients have dramatically changed the outlook for these patients when the right services are available. For example, in the mid-1970s, people with burns covering more than 20 percent of their bodies almost always died.

Now, more than 50 percent of burn patients are treated in specialized burn centers, and people with burns covering 90 percent of their bodies can survive. In 2005, we invested $3.7 million to move the Burn Center to its current location on 11 South, VUH, creating one of the nation’s largest specialized burn treatment facilities. Many people are surprised to learn that Vanderbilt supports the only dedicated burn center in Tennessee with large-scale, comprehensive resources for inpatient and outpatient services. Thousands of adult and pediatric patients arrive at the Burn Center’s doors each year.

These teams lead the nation in all of our missions surrounding care for the most severely injured patients — education, research and extraordinary care — and literally define how emergent life-saving care should be delivered. Remarkable improvement in survival for acutely injured patients over the last 40 years has occurred, in large part, due to NIH-sponsored research at Vanderbilt and peer institutions revealing the best approaches — from fluid resuscitation and wound cleaning to advances in nutritional support and infection control. Research has remarkably improved both survival rates and quality of life for those surviving serious injury.

Yet trauma is still the leading cause of death for Americans under the age of 40. More years of potential life are lost due to injury than to heart disease or cancer. People are injured in motor vehicle accidents, acts of violence, and countless other ways. Serious injury is a never-ending part of the human experience. The World Health Organization projects that by 2020 injury will surpass infectious diseases as the leading cause of death worldwide.

Each year in the United States, more than 2 million people are hospitalized for treatment of a traumatic injury. The cost of injuries due to motor vehicle crashes alone exceeds $100 billion/year. A study in the July issue of The Journal of Trauma Injury, Infection and Critical Care found that the added cost of treatment at a trauma center like ours is $790,931 per life saved. This paper and many other studies also confirm that when care is provided at dedicated centers capable of managing the full spectrum of needs for the critically injured, survival rates and functional status after injury are vastly improved.

When considering the myriad challenges and choices we make every day, I remind myself that the thousands of injured patients who cross our doorstep each year are not just faces in the crowd. They are our family members and our friends. The incredible teams of dedicated people at Vanderbilt standing ready 24/7, 365 days a year, never ask “why.” They never stand in judgment. They just rescue us.

Jeff Balser, M.D., Ph.D., vice chancellor for Health Affairs and dean of the School of Medicine




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