General Surgery Residency Program

Randy Woods, M.D., FACS, Director

Trauma Program

Shaw Emergency and Trauma Center
Shaw Emergency & Trauma Center

Miami Valley Hospital is an 848-bed regional referral and specialty center and one of seven major teaching hospitals in the Greater Dayton area affiliated with Wright State University Boonshoft School of Medicine. The facility is a 20-year ACS-verified Level I Trauma Center (with nearly 3,000 trauma admissions and 500 emergency surgery admissions per year) and a regional Burn Center, and is the only such facility in southwest central Ohio.

Supported by three Eurocopter Dauphin Helicopters (two located on site), the hospital's Shaw Emergency and Trauma Center is the busiest emergency room in the state of Ohio. Each year, the staff (including board-certified emergency physicians and emergency-trained nurses) provides care to more than 100,000 patients. The facility was expanded and renovated in 2000, and includes a 41-bed ultramodern medical-surgical ICU, with new medical-surgical general care areas, to make it one of the region's most current emergency care facilities as well.

The 71-bed emergency department (ED) has private rooms for all patients. Each room is equipped with a computer for bedside registration, clinical documentation and order entry, which allows patients to receive care more quickly. The unit includes its own imaging facility, so patients can get a CT scan without moving elsewhere in the hospital. The dedicated stat lab is open 24 hours a day for immediate testing and fast results. All aspects are focused on getting patients the right care as quickly as possible.

MVH's Level One Trauma Center and close proximity to CareFlight's home base a few floors above give the Emergency Department the ability to handle the region's most serious emergencies. The MVH ED also has a special Hazmat area to respond to patients exposed to hazardous materials.

The Trauma Program administration assigns attending surgeons to respond to the admission of all multisystem trauma patients on a daily basis. At the present time, there are six general surgeons who rotate first and second call. The director of the Burn Center and the chair of the Wright State University School of Medicine Department of Surgery also take second call. Trauma attendings rotate on a 24-hour schedule and are activated by the Trauma Alert beeper system. This attending works closely with the Trauma chief resident to coordinate all services required for the admission of the trauma patient. The Trauma Program also has a Trauma ICU attending on call. This attending rotates on a weekly basis, changing Monday at 7 a.m. The Trauma ICU attending makes daily rounds in the ICU and on the surgical units to assist the Trauma Service residents with the coordination of in-house trauma care. This attending also provides administrative coverage, facilitates flow through the hospital and provides administrative consultation and support. Trauma attendings are appointed by and credentialed by the trauma director, who is also chair of the Section of Trauma Surgery.

The Trauma Service consists of one surgical team covered by a PGY-5 (Trauma chief resident), a PGY-3, a PGY-2 and a PGY-1. This in-house resident staff covers the admission of all multisystem trauma patients presenting to the hospital from 7 a.m.–5 p.m. during the week. The PGY-2 resident is assigned to cover the patients in ICU. There is also a PGY-1 resident assigned to the Neurosurgery service. At night and on weekends/holidays, there is a PGY-4 or PGY-5 in-house to respond to Trauma Alerts and begin evaluation and treatment of the patient. If a patient is taken to the O.R., the admitting PGY-5 assumes responsibility for the patient's care. The Trauma attending participates in all major therapeutic decisions, is present for all operative procedures, monitors patients in the ICU daily and rounds on the ward patients on a regular basis.

In addition to the surgical physician coverage provided by the Trauma Program, there are three trauma nurse specialists (TNS's) who work with the on-call trauma team to monitor the patient's progress, keep family members informed, and provide follow up information to family physicians. There is a TNS in-house seven days a week from 7 a.m. to 5:30 p.m. to provide trauma case management services.

After the Trauma Service patients are discharged from the hospital, they are referred to the Trauma Outpatient Clinic. The Trauma Outpatient Clinic provides follow-up care for trauma patients and their families. A Trauma attending, the trauma service residents, and the TNS's staff the Trauma Outpatient Clinic on Monday and Thursday from noon to 4 p.m. for patient appointments.

The Trauma Program is actively involved in several multicenter research studies, including NIH and CDC grants. The Trauma Program is also involved with several injury prevention projects. Among these are the CareFlight "Drive Smart" program for teens, a dramatic demonstration of alcohol related vehicle accidents; Emergency Nurses C.A.R.E., a slide show provided to high school students describing the effects of alcohol on judgement and motor skills; and sports medicine seminars designed to prevent sports related injury.

The Trauma Program promotes helmet safety, gun safety and education programs to reduce falls in the elderly through its active participation in the Injury Prevention Center for the Greater Dayton Area with representatives from six Montgomery County hospitals, Wright State University School of Medicine and United HealthCare.

The Trauma Program is active in providing comprehensive EMS educations programs and offers courses for trauma care providers, including ATLS, TNCC, CATN and BTLS.