| Emergency Department |
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 Specialized
trauma care
at Salinas Valley Memorial’s Emergency Department |
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 Caring for patients who have suffered a major trauma is a specialized field within emergency medicine. Trauma care is for people with sudden and severe blunt or piercing injury most frequently caused by motor vehicle accidents, gunshot and knife wounds, falls, physical battery and burns.
While external evidence of trauma may be obvious—broken bones and cuts for example—problems such as internal bleeding, a severed artery, and organ and tissue damage are more challenging to assess. Often patients who’ve experienced a severe trauma have multiple complications that must be quickly identified and addressed simultaneously. For example, a person who has a heart attack while driving can suffer trauma in a motor vehicle accident in addition to the heart attack.
The Emergency Department (ED) features a large dedicated, specially-equipped trauma room with separate areas for two patients. Medications, trays of sterilized tools, equipment for inserting tubes, breathing devices and central IVs are ready at all times. Because trauma care frequently requires surgery— general, vascular or neurological for example— surgeons and operating room facilities and staff are on stand-by around the clock.
“We also have a new 8-bed Clinical Decision Unit (CDU) that can serve as an observation area for our trauma patients,” says Nuala Rippere, RN, Director of Emergency Services for Salinas Valley Memorial Healthcare System. “Patients are kept up to 24 hours in the CDU if the ED physician needs to observe them longer in order to make a decision to release or admit them to the hospital. It’s also helpful for patients who need stronger pain medications, repeat diagnostics or close observation. The CDU environment can make a real difference for patients and their families who are already anxious, fearful and stressed.”
“Traumas are often life-threatening and speed is absolutely critical,” says James Stubblefield, MD, FACED, Director of the Emergency Department. “The first step is to assess the person and determine the best course of action, whether that involves scans, laboratory tests, emergency surgery or transfer to another hospital for specialized care. Our emergency physicians, physician assistants and nurses work together as a team to identify the problem and the best treatment as quickly as possible. Trauma care is always evolving in concept and practice, but we basically have less than one hour to make critical decisions.”
“Survival of victims of trauma not only depends on the care we provide here at Salinas Valley Memorial, but also on strength of the trauma system throughout the community and Central California,” says Dr. Stubblefield. The trauma system involves ambulance services, both air and ground, emergency medical technicians (EMTs) and paramedics, and regional trauma facilities that specialize in multi-system trauma, burn care, amputation and reimplantation. “It takes the entire system working together to reduce the number of lives lost to trauma.”
Patients with specific traumas, such as severe burns, can be transported directly to the Burn Center at Santa Clara Valley Medical Center, for example. If the patient needs to be stabilized, he or she is taken to the nearest emergency department, and later transported to the specialized medical facility. Often, patients are returned to Salinas Valley Memorial once they have been treated at the other facility so they can continue their healing and treatment in the local community.
“Paramedics and EMTs who staff the ambulances alert us as to each patient’s condition,” says Rippere “If we know that a ‘code 3’ patient is on the way, that means all hands on deck—we have to be prepared for anything.”
EMTs and paramedics provide ED staff with detailed data including the nature of the injury or illness, current condition and vital signs so that everything is in place when the patient arrives. “If we have a heart attack victim on the way, we alert the cath lab and cardiologists,” says Rippere. “If there’s head trauma, we can call in the neurosurgeon. For severe infant and pediatric emergencies, we can call on our pediatricians and neonatologists.”
In addition to ten Emergency Medicine Physicians and six physician assistants, the Emergency Department is staffed by 70 Registered Nurses, three Licensed Vocational Nurses, 17 Clinical Assistants and three clerks. “Many of our nurses have completed specialized training such as the Trauma Nursing Core Course and the Emergency Nurses Pediatric Course,” says Rippere. “We encourage our registered nurses to complete this important credentialing within their first year of working in the Emergency Department.”
Salinas Valley Memorial’s Emergency Department is staffed by board-certified emergency medicine physicians and nurses with specialized training, and equipped with the latest advancements in life-saving technology. The Emergency Department’s trauma team is prepared for literally anything, every minute of every day.
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Emergency Department expansion
The Emergency Department of Salinas Valley Memorial Healthcare System will soon undergo a major expansion, with construction scheduled to begin within the next year and be ready for occupancy within 18 months.
The current Emergency Department (ED), built in the 1950s, was designed to accommodate 12,000 to 15,000 patients each year. With steady population growth in the Salinas Valley, Monterey County and the Central Coast Region, our Emergency Department now cares for 32,000 to 36,000 patients annually, more than double the initial capacity.
The new 14,700-square-foot L.M. Tynan Emergency Department will extend into the area currently occupied by administrative offices. The number of beds will nearly double, from 14 to 26. A new open bay floor plan will incorporate a centralized nursing station and  patient monitoring system. There will be five specially-equipped cardiac rooms, three trauma rooms, and one designed for pediatric emergencies. As with the current ED, the new Emergency Department will feature state-of-the-art technology to support emergency medicine professionals in caring for people with serious or life-threatening illnesses and injuries, including a dedicated CT scanner to be located in the ED.
For patients with non-life-threatening and minor illnesses and injuries such as earaches, minor cuts and mild respiratory conditions, there will be a “fast track” registration procedure to reduce waiting time. |
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