Trauma Research and Teaching

Trauma research plays a crucial role in the ability of a trauma system to adapt to meet the trauma care needs of the community it serves.  As the region’s only ACS Level-I trauma center, Stony Brook Trauma Center receives most of the severely injured patients in Suffolk County.  Access to current regional data, a multi-disciplinary group of experienced trauma professionals, and an academic alignment with the Stony Brook School of Medicine enables Stony Brook Trauma Center to remain continuously engaged in trauma research.  This distinguishes Stony Brook from other regional trauma centers, driving improvements in trauma care, and optimizing survival of the injured patient.

Research Examples:

  • Review of patients with cardiac pacemakers and defibrillator in place prior to their injury identified that these patients are high risk for complications. Clinicians have altered practice to include early consultation with cardiac specialists to fully evaluate the pacemaker device and assess its functioning. Altieri MS, Almasry I, Jones T, McPhee C, McCormack JE, Huang ED, Eckardt P, Shapiro MJ, Eckardt S, Vosswinkel JA, Jawa RS. Implantable Cardioverter defibrillators and permanent pacemakers: prevalence and patient outcomes after trauma. Am J Surgy 2016 Nov:212(5):953-960
  • Trauma surgeons identified a higher than expected incidence of spinal fractures occurring in low-level fall injuries and modified practice to include comprehensive radiologic examination of the spine to provide accurate and timely care. (Jawa RS, Singer AJ, Rutigliano DN, McCormack JE, Huang EC, Shapiro MJ, Fields SD, Morelli BN, Vosswinkel, JA. Spinal Fractures in Older Adult Patients Admitted after Low-Level Falls: 10 year Incidence and Outcomes. J Am Geriatric Soc. 2017 May; 65(5):909-915)
  • An interdisciplinary group of trauma team members conducted an electronic national survey of over 400 trauma surgeons and reported on the use of a drug used to treat acute bleeding (hemorrhage). Jawa RS1, Singer A, McCormack JE, Huang EC, Rutigliano DN, Vosswinkel JA. Tranexamic Acid Use in United States Trauma Centers: A National Survey. Am Surg. 2016 May;82 (5):439-47
  • Trauma surgeons at Stony Brook evaluated patients who had a change in their condition and required an upgrade to an intensive care unit (ICU). These events were associated with poor outcomes. The group then changed their clinical practice and began to admit patients over age 65 with significant thoracic (chest) injury to the ICU. This practice change was evaluated and found to be beneficial to both patients and to the trauma center. Patient outcomes were improved, and total ICU days were reduced. Preventing complications that lead to ICU necessity are important. Rubano JA, Vosswinkel JA, McCormack JE, Huang EC, Shapiro MJ, Jawa RS. Unplanned intensive care unit admission following trauma. J Crit Care. 2016 Jun;33:174-9. And O Pyke, JA Vosswinkel, JE McCormack, EC Huang , RS Jawa. Admission Of Older Blunt Thoracic Trauma Patients To The Intensive Care Unit (ICU) Improves Outcomes. Academic Surgical Congress, February 8, 2017, Las Vegas. Oral presentation
  • The Trauma Center examined regional data to explore outcome of patients who require long term use of mechanical ventilation (artificial breathing machine) after traumatic injury. Outcomes were better for these very critical patients at the highest level trauma centers. Rubano JA, Paccione MF, Rutigliano DN, Vosswinkel JA, McCormack JE, Huang EC, Yang J, Shapiro MJ, Jawa RS. Outcomes following prolonged mechanical ventilation: Analysis of a countywide trauma registry. J Trauma Acute Care Surg. 2015 Feb;78(2):289-94

Presentations:

Medical professionals share knowledge and advance clinical care by sharing outcomes and guidelines at the annual meetings of professional healthcare organizations. Our faculty and staff have actively participated in these educational exchanges:

National Presentations:

  • Kristi Ladowski, MPH (Injury Prevention Coordinator) presented at the Academic Surgical Congress on work relating to the Traffic Violator Program in Suffolk County. Her report identified that these high-risk drivers are unaware of the risks they take, and after the program are more likely to identify the need to change their driving behavior.
  • Jane McCormack, RN (Trauma Program Manager) presented at the Trauma Center Association of America about the trauma center’s recent revision of the documentation tool used to record the rapid-fire events of trauma resuscitation. These efforts have resulted in an interdisciplinary tool that accurately reflects the care and treatment of a critical trauma patient.
  • Randeep Jawa, MD, FACS (Trauma Surgeon) presented at the Academic Surgical Congress on the significance of contusions (bruising) of the lung, and how it can best be evaluated.
  • Jane McCormack, RN (Trauma Program Manager) presented at both the 2015 and 2016 Annual Meeting of the Trauma Quality Improvement Program (TQIP). (www.facs.org/quality-programs/trauma/tqip) The work included developing a collaborative research group and enhancing training for trauma registry staff.

Local and Regional Presentations:

  • Colby Rowe, EMT-P, MS (EMS Outreach Coordinator) was an invited speaker at the annual meeting of the Suffolk Emergency Nurses Association. He talked about the Bleeding Control (B-Con) program and how hospitals can get started to educate the public on this important initiative.
  • Jane McCormack, RN (Trauma Program Manager) has lectured at the Stony Brook University School of Nursing on both Use of Large Data Sets, and Injury Prevention.
  • James Vosswinkel, MD, FAC (Trauma Medical Director) and Jane McCormack, RN (Trauma Program Manager) were the invited lecturers at the JT Mather Annual EMS dinner in 2016.

Training and Education:

The Trauma Center staff is involved in professional and public education every day. As an academic teaching hospital with training programs in medicine, nursing, physical and occupational therapy, physician assistants and paramedics, our staff is familiar with bedside clinical teaching, didactic presentations and the development and use of clinical simulation for training.

Some examples:

  • Stony Brook Trauma Center is Suffolk County’s only site to offer Advanced Trauma Life Support (ATLS ™) (www.facs.org) training for physicians and physician extenders. ATLs™ is the common language of trauma resuscitation and outlines the critical steps necessary to identify and treat life threatening injuries. Each year over 60 physicians are trained (or recertified) in these techniques.
  • In our efforts to maintain excellence, our trauma center staff conducts regular education for staff members. The Trauma Center offers quarterly “Lunch & Learn” programs with Clinical Education Units (CEU) awarded. In addition, all staff nurses complete an annual on-line trauma center training.
  • The Stony Brook Trauma Center has conducted a one-day Trauma Registry Conference in collaboration with the Stony Brook University School of Nursing. This annual event is now in its fourth year, and is looking forward to a new location at the Phillips School of Nursing at Mount Sinai Beth Israel in New York City on August 19, 2017. Register at https://nursing.stonybrookmedicine.edu/continuingeducation
  • Stony Brook is proud to partner with Suffolk Emergency Nurses Association to offer TNCC™ training for registered nurses. TNCC (www.ena.org) is a two-day course that includes both lectures and clinical skills for bedside nurses.
  • Stony Brook Trauma Center serves as the host for the quarterly meetings of the Suffolk Regional Trauma Advisory Committee (RTAC). The RTAC is tasked with oversight of the trauma system in Suffolk County. Its membership includes representatives from all other trauma centers, the Department of Health, Suffolk County Police Department and others. These meetings have recently begun offering Continuing Medical Education (CME) credits to the physicians who attend. Stony Brook serves as the regional leader for trauma care.
  • Trauma care begins at the moment of injury, and the Stony Brook Trauma Team is very involved in education with the dedicated members of the Emergency Medical Services (EMS) community. Our county is served by over 100 individual EMS agencies, and the Trauma Center interacts with nearly all of them. Our faculty and staff offer training in Pre-Hospital Trauma Life Support (PHTLS)(www.naemt.org) for EMS providers.
  • In 2015, the Board of Emergency Nursing began offering specialty certification in trauma nursing. Specialty certification is a recognition of a broad scope of knowledge and a deep understanding of key trauma concepts. Both our adult and pediatric trauma program managers have attained this certification, as have several of the nurses working in our Level I Trauma Center Emergency Department.