Trauma Program at Blake Medical Center


(bright music) Hi, I’m kelly Carlstein
from Blake Medical Center, and this is Healthy Living,
a show that brings you the information that you
need to live a healthier, happier life. On today’s episode, we’ll be talking about the Trauma Program
at Blake Medical Center. I’m very happy to have
a special guest today, Dr. Brian Kimbrell, the
Medical Director of Trauma at Blake Medical Center. Thanks for joining us today. Thank you for having me. Let’s start by you telling
us a bit about yourself. Well, my name’s Brian
Kimbrell, as you said, originally from Southern Illinois, went out to California, Los Angeles area, to do my surgical residency, where I did general surgery residency. While I was there, I
was exposed to trauma, and then did my fellowship out there, and lived out there for quite a few years practicing, doing trauma. Then, I came out here in 2010 to help open up the trauma center here. That’s basically how I got here. What made you want to become a physician in the first place? That’s a good question. I always think about that. So, I’ve got a lot of things. One, I think, is my sister actually is about 10 years older than I. She went to nursing school. I always thought it
was kind of interesting when she would come back, and bring back some of her text books and things. I’d kind of sneak at them
when I was eight years old. It kind of seems lame,
maybe, but I had this weird, I call it, sounds bad but sort
of a hero complex in a way. When I was a kid, any
time somebody got hurt, or something like that, I
always wanted to come over and try to help them. Then, I had quite a few
friends when I was growing up whose fathers or mothers were physicians. Something about it just
kind of inspired me. So, when I was a kid, I
remember telling my dad I wanted to be a doctor,
and he was like well, okay, that’s a lot of work, but
whatever you want to do. I just kind of stuck with it. It was always something
in the back of my mind that I wanted to do. Tell us about the education, and how, what it takes to become a trauma surgeon. So, first, you finish college, and then you go to medical school. So, that’s a four year program. After medical school, you apply for a general surgery residency. That’s five years, typically. Sometimes it could be a little bit longer, according to if they have
research years or whatever. After that, I did a two year fellowship in trauma and surgical critical care. All of that was in the Los Angeles area. With that, one year I was just
doing surgical critical care, running a surgical ICU. We would do some trauma calls. Then, the next year you
ran a trauma service, and some of the patients
in the ICU and not. So, that’s basically how,
many years to be honest. You wake up from that and all of a sudden you realize how old you are. What does it mean to
be the medical director of a trauma program? Well, basically, there’s
a lot of facets to that. You have to make sure, first of all, that you have all the requirements
in place for the state, and the American College of Surgeons, all the different requirements,
that they’re in place. That includes having all
the service lines in place, ICU’s, etc., and functioning
properly, educated properly, to manage the trauma patient. Make sure you have the sub-specialists’ call panels in place, like orthopedics, neurosurgery, plastic
surgery, ENT, etc., etc. And, making sure that call is
always covered for all those, including then, overseeing
the trauma surgeons in that program, and kind of overseeing that the care of those
patients is doing well, is being given well. Also, the trauma director oversees all the performance improvement
process for the whole entire trauma service line. So, that’s not just the trauma surgeons, but orthopedics, and the neurosurgeon. We have to look at all
cases, and if there’s ever any complications or anything else, see if there’s anything that could’ve been done different, etc., and how to improve upon care and give the best care possible. So, multiple facets to it. And, what determines that
a patient is a trauma? And, what would cause them
to come to a trauma center? So, there are specific injuries, or things out in the field,
when someone’s outside, before they get to the hospital that trigger a trauma
alert as they call it. Now, that differs a little
bit from state to state. It can be state based, or even
county based in some places. So, those things trigger
an automatic trauma alert in Florida, the state criteria. In addition to that, being a trauma alert, there’s patients who might come in who aren’t a trauma alert,
but when they come in you find that they have specific injuries, severe injuries, that need to be admitted to the hospital, or need to have someone overseeing that care, and that would be the trauma service or trauma surgeon. As far as going to a trauma center verses your regular hospital,
again all trauma alerts go to trauma centers. Basically, the things
that they’re looking at with that, or the ones
that are made so typically, really severe injuries,
or multiple injuries. If someone has maybe a broken leg and rib fractures,
abdominal injuries, etc., or head injuries,
definitely head injuries, bleeds in the brain would go to typically a trauma center to be managed. What makes the hospital
that has a trauma center different than a hospital
that just has an ER? Well, number one is the
trauma surgeons, we’re here, so trained in trauma and
immediately available. So, when the trauma patient
comes in, we’re right here. That’s the first thing. We have certain other things all in place, having all the specialties in place. So, we have neurosurgeons who
are available immediately, orthopedic surgeons, all these aspects. A lot of hospitals may
have people on call, but they can’t be there
immediately to maintain it. We have an operating room that’s available immediately for us. It’s awaiting any trauma
patient to go into it. We have education throughout the hospital with nursing staff and other
staff on trauma management. Again, like I mentioned,
the state of Florida itself has rules on what you have
to have in place, ongoing, as well as the American
College of Surgeons with that. So, it’s just an entirely
much higher level of care, and the speed of it that it
can occur is much different. We’re gonna take a short break, and then we’ll be back with more on the trauma services
at Blake Medical Center. (bright music) – [Narrator] We are Blake Medical Center. – [Narrator 2] We are
leaders in surgical care. – [Narrator 3] we are trained in minimally invasive techniques. – [Narrator 4] Such as da
Vinci Robotics surgery. – [Narrator 5] We are
committed to giving you personalized options. – [Narrator 6] Because to
us, it’s all about you. – [Narrator 7] Your health. – [Narrator 8] Your well-being. – [Narrator 9] Your quality of life. – [Narrator 10] Blake Medical Center, exceptional care for everyone. My name is Spencer Faust, and I currently go to SCF for college. I was a junior in high school when I got in the car with one of my friends. We were driving home
from a friend’s house, and we had lost control, and hit a tree. (siren in distance) I got the phone call in 2013 from Blake Trauma Center
that my son, Spencer, was in a major car accident. He was a passenger in the car, and he wasn’t supposed to make it. He had several shattered bones. Well, this arm completely shattered. So, they had to go in right here to basically put the bones back together. Go in through the top, and
put a titanium rod in there, and finish it off with a screw right here and two screws over here
to hold it in place, and 14 screws right over here, big titanium plate, too. I had broke two ribs,
punctured both my lungs, punctured a kidney and
a liver, my sternum, and broke this right shoulder blade. I broke my pelvis in five places. Well, Blake Trauma Center’s the one that who even found out who my son was. There was no ID or anything. All that was wrapped up in the car. They couldn’t even retrieve it. It took days to find out who he even was. Then, I got a call from
Blake Trauma Center. I wasn’t supposed to originally make it. So, Blake Medical Center called my family. I have family in
Connecticut, Germany, Ohio, and everything. They just all flew down
here to say their goodbyes. But, Blake did a good job. I’m here, so. I’m back to my full potential that I was. There’s nothing that I can’t do. I can play on the guitar
just like I used to. I can still kayak and canoe. I can do anything I want,
100%, 110% actually. The Trauma Center at Blake Medical Center was phenomenal. It’s the whole reason
why my son is here today. Hands on, did everything
they could to give me my son. (soft music) (bright music) Welcome back to healthy living. I’m Kelly Carlstein, and
joining me now is Dr. Kimbrell. Can you tell us more
about the trauma program at Blake Medical Center? Well, we opened in 2011. We were designated by the
State of Florida then. Then, have been since verified by the American College of Surgeons. We’re actually the second trauma program in the State of Florida to be verified by the American College of Surgeons. It was a great feeling
for us to accomplish that. We have currently five
surgeons, trauma surgeons, and we’re actually adding
a sixth trauma surgeon with extenders who help work with us. Basically, we are here to
manage the trauma patient. We’re here in house awaiting a patient to come in and manage
them, operate on them, get all the other specialists that may need to be involved here
to see them as well. We care for them throughout their whole entire hospital stay,
and make sure that they have follow-up appointments with us and any of the other
specialists that they need. Overall, it’s a great
program, a great team. The team isn’t just the
trauma surgeons themselves, and the extenders who work for us, but really, if you think about it, a trauma center is the entire hospital. We work very closely
with the emergency room, the emergency room physicians, nurses, the operating room, the
OR, the nurses there because we may have to
go there, radiology, going to the CT, other films,
the ICU, the regular floors. We always say we go from out in the field, the EMS side, all the
way to ER, OR, ICU floor, to rehab, which we have here as well, which is a part of our
team, to final discharge. So, it’s just the entire
hospital and the great group who all work together and
love making people better. And, you mentioned being verified by the American College of Surgeons. What does that entail? It’s a process. It entails, there’s rules
that they bring out. Every few years, they
update what they call The Optimal Care of the Trauma Patient. It has all of the requirements
that must be in place to be verified by the
American College of Surgeons. It’s a national thing,
and in fact, some places internationally are now
utilizing these rules as well. So, you basically put all
these things in place, make sure they’re all up and running. You fill out an application that you send to the American College of Surgeons. They then will come and do a survey. They bring surveyors
that are nationally known who come to the hospital. They go through all of your charts, reviewing the performance
improvement aspects as well as the care that was done. So, we look at a year’s period of time. Then, they tour the hospital, making sure that all of these things are in place. They can come and ask
questions, and interview all the department heads,
and all the service lines, and all the sub-specialists
about what is in place, who all is on call, how
many levels down does it go. After that, they have an
actual exit interview with you. A week or two later
you get a final report. They have a board that they all meet with. So, not just those surveyors,
but the entire board, the national board will meet,
and discuss your hospital and their findings, and
notes that they took. Then, getting notification
whether you succeeded or not in your verification. It’s kind of an intense process, but it keeps you on your
toes, and makes sure that everything’s in
place and running well. As a trauma surgeon, what are the most common injuries that you see? Well, it varies, of course wherever you’re located a bit, but nationally, believe it or not, and
kind of is ours as well, currently, the national
number one mechanism or type of injury that you
would see is actually falls. This can even be from
heights, like a story, or two, or three, or
even ground level falls, meaning somebody just walking,
and they trip and fall, or maybe stumble over something. A lot of times you would
think that a ground level fall would not be that serious,
but with certain age groups, etc., on certain medications
that may cause bleeding, it could actually be life-threatening. So, that’s actually
nationally the number one mechanism now, or type of injury. There are things that we see. The next ones would be
car accidents, of course, motorcycle accidents,
bicyclists who are hit by cars, or people walking hit by cars. That’s something I can’t
really say enough about. We actually have a large amount of that. I think as a driver, you
have to be very cautious, but also pedestrians need to be careful. Sometimes you’ll see people just go out across in the middle of the
road at not a crossing point. So, we actually have a lot
of people hit that way. The other injuries, of course assaults. Then, stabbings, gunshot
wounds, water sport accidents, boating accidents, jet
skis, things like that. What does the treatment process look like for somebody that comes
into a trauma center? So, it starts out in
the, we call it the field where the EMS or the ambulance
service sees the patient. They’ll get them, bring them to us. When they come into a trauma bay, we have a large team that’s there: trauma surgeon, ER
physician, a few nurses, X-ray tech, respiratory therapy, etc. When they first come in, we make sure that we have their vital signs,
make sure they’re stable, asses them, what we call primary survey, check and make sure their
airway, they’re breathing, airway’s open, they’re
breathing, that they have good blood pressure, pulse, nothing actively bleeding, try
to stop that immediately. Then, start assessing other
things like their mental status, and whether everything’s moving. That’s the primary survey. Then you start doing the
specific X-rays that you need. Then, we have what we
call secondary survey which is where we really
just go head to toe looking at everything
in detail, looking for every scratch, every little
cut, maybe a broken bone, or swelling that you didn’t
notice on that primary survey. The quick primary survey is
more of a life-saving thing, so something you need to
take care of right away. Then, after that, we then
decide if we need cat scans or not, and take them to get a cat scan. Then, or, go straight
to the operating room. Sometimes we do that, just straight in and go straight to the operating room, and then determine whether
the injuries that they have are again severe enough
to go the operating room, or be admitted for, but
most of them will be if they’re coming to us. Admit them to the ICU verses the floor, and then go from that process. If there’s certain things
that are life-threatening, sometimes you can have
a lung that’s collapsed from a trauma. Rib fractures may collapse a lung. We’ll have to put a tube in immediately to decompress that so they
can continue to breathe and their blood pressure’s okay. We may have to give blood products to get their blood pressure up. While we’re getting ready to rush them to the operating room
to stop that bleeding. And, what are the most common situations that cause traumas? I would imagine not wearing your seatbelt, not wearing a helmet. So, if you kind of go
through, as I mentioned, the different types of things that can cause an injury, if you
think about each one, there’s things you can do
to try to help prevent it. So, if we go with falls, making sure if you’re on a ladder that it’s stable. As we get older, maybe
it’s not the best idea to be up on ladders. If you really have some
problems with dizziness and things like that, or
being able to walk well, you probably shouldn’t be climbing up on the roof and fixing things. So, that’s definitely
something to think about. At home, also with the ground level falls, a lot of people trip
over rugs, other things that are laying around. So, just try to keep things up like that. When you talk about
motor vehicle collisions, also seat belts for sure. You know, they’re known to save lives, so everyone should be wearing a seatbelt. I know that there’s a lot of people you get in their cars
with them and you notice that people in the back seat often, it’s an interesting
phenomena I’ve noticed, everybody in the front
seat thinks about clicking their seat belt, but in the back it seems like people don’t always think about it. You still have that same risk in the back. I’ve seen people who have been thrown over the seats above and out the window because they didn’t put
one on in the back seat. Other things would be
of course motorcyclists wearing helmets. It’s not the law in Florida,
but I believe it should be. By the way, I believe everybody
should wear them at least. It really can save lives,
and save not only lives, but brain injuries. So, those are some of the major things to kind of think about. I think prevention is really a major part. Going back to wearing seat
belts and car accidents, just being safe when you’re driving, looking both ways before you go somewhere, looking for pedestrians, paying
attention to the stoplights. I can’t remember how many years ago now, we used to call motor vehicle accidents, and I may have just said that even out of thinking historically, but nowadays they call them motor
vehicle collisions instead. They tried to get rid of
the terminology of accidents because they say pretty much all accidents are preventable, or
motor vehicle collisions are preventable. So, we’re not gonna call
them accidents anymore. We’re gonna take one last break, and then we’ll be back with more on the Trauma Program
at Blake Medical Center. – [Narrator] We are Blake Medical Center. – [Narrator 2] We are
leaders in orthopedic care. – [Narrator 3] We are
experts in procedures like hip and knee replacement surgery. – [Narrator 4] We have been recognized for our clinical excellence. – [Narrator 5] We are committed to giving you the best care. – [Narrator 6] Because to
us, it’s all about you. – [Narrator 7] Your health. – [Narrator 8] Your well being. – [Narrator 9] Your quality of life. – [Narrator 10] Blake Medical Center, exceptional care for everyone. And yet, I’m still here. I shouldn’t be alive, but I am. It wasn’t my time. I wasn’t supposed to survive, but I did because of the Blake
Medical Trauma Center. (soft music) (bright music) Welcome back to Healthy Living. I’m Kelly Carlstein, and
I’m joined once again by Dr. Kimbrell. Let’s talk more about
how to prevent trauma when it comes to water sports. So, I think number one is always, especially for children,
having their life preservers on when boating, etc., in case
they fall overboard, etc. Even for adults, make
sure that you have enough life preservers on board,
all the safety things for your boating, etc. Also, being cautious of
mixing drugs and alcohol which is a problem for
cars, etc., motorcycles. On the water, it’s
still a definite problem where people may not be
as careful as normal. Other types of things
to be concerned about, of course, is even just swimming pools, having your children, making sure you know where your children are, watching them whenever you’re at the
water, either a pool, or at the ocean, etc. Just being overall safe and cognizant of the potentials of not just drowning, but other accidents that might occur. Does our trauma program have any community education or outreach
prevention aspects to it? Yes, we have a performance improvement and outreach person. Her name is Cindy Tanner, who goes out and does a lot of education for schools, from elementary schools all
the way to high schools, with different aspects, talking
about drinking and driving, or other safety type issues. She also is very involved
with other organizations in educating them and helping them with educating others, working again on things I spoke about: fall preventions, working with fall prevention programs. So, she’s extremely active with that. The hospital as a whole
is active with that. We also have outreach to other hospitals. I’ve gone to different hospitals where I educate them on trauma care, and when to transfer patients, how to do that initial management
before transferring it, and who are the patients that
would be best transferred. We’re also gonna be soon
working on a program that the American College of Surgeons has called Rural Trauma Program. It’s basically that same
line, but more formalized, of going out to outside
hospitals to make sure that they can deal with these traumas, get them stabilized
before transferring out. How does having a trauma
center in our community benefit us locally? Well, basically I’ve
always said that the name of the game in trauma is time. The sooner you can get to a center where you can get your definitive care, you get the bleeding stopped,
you get the injuries fixed, then the sooner you will be recovering, and the better chance
you have at survival. Multiple studies have demonstrated that the further away
you go, the longer amount of time it takes to get
that definitive care, the higher mortality is,
or your risk of death. Also, the higher your
complication rates are. So, having a center here locally, you could be here within,
I would say typically around our area, within
15 minutes at the longest, you would be in the center itself. Then, we’re here immediately
to take care of the patient. In the past, before we were open in 2011, patients would either
go to local hospitals and then have to be transferred somewhere like Tampa or somewhere else. Or, sometimes they would
take that long ride or helicopter ride, but with bad weather, often the helicopters can’t fly, so a long ride across the
bridge if the bridge was open. So now, again, you have it
here locally, it’s close, faster, better survival
rates, and less complications and problems. What would you say the most rewarding part of your career as a trauma surgeon is? Well, you know, overall, helping people, but with that comes, you know sometimes you have some cases that you just remember more than others. Some of the ones that
always stick with you are the ones where someone came in and had expired prior to being just coming through the door or right in front of you, but you were able to go and aggressively perform a procedure or
operation and bring them back, and them survive and go home. To me, that’s probably the most rewarding. Even people with just a broken arm or leg, seeing them to where they can get back to where they can walk and go back to work is rewarding as well. Of course, those bigger
cases always kind of stick with you and kind of
definitely push you forward. What’s the one thing that you would like everybody to know about the Trauma Program at Blake Medical Center? Well, that we’re here, and we’re here to take care of them or their families if, unfortunately, they’re
involved in any type of trauma. It’s a great thing to
have in your community. It’s a program I’m very proud of. The other thing I would just add is just that everybody think about prevention, and how to try to be as safe as possible, especially maybe in the
summertime, people are out even more, and even more
potential of injuries. Really, every day just
think about being safe. Well, thanks so much for joining us. Alright, thank you. That’s all the time we have for today. If you would like more
information on today’s guest, please visit us at blakemedicalcenter.com and click on the Healthy Living Talk Show. While you’re there, you can also send me your comments, or suggest a topic for one of our upcoming shows. I’d love to hear from you. I’m Kelly Carlstein
wishing you Healthy Living. (bright music)

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