Los Angeles County's newest trauma center in downtown Los Angeles has treated nearly twice as many patients as anticipated in the first three weeks of its operation and is expected to receive even more when the trauma unit at Martin Luther King Jr./Drew Medical Center closes Feb. 1.
The unit at California Hospital Medical Center on Grand Avenue has been bustling since it opened its doors Dec. 1, treating about 75 patients suffering from extreme injuries, including stabbing and gunshot wounds, and injuries suffered from falls and car accidents.
For The Record
Los Angeles Times Saturday December 25, 2004 Home Edition Main News Part A Page 2 News Desk 1 inches; 61 words Type of Material: Correction
Trauma center -- An article in Friday's California section about a new trauma center at California Hospital Medical Center in downtown Los Angeles said the trauma center at Martin Luther King Jr./Drew Medical Center would stop seeing patients Feb. 1. The exact date of the shutdown has not been determined; officials have said it would be between late January and mid-February
If the pace continues, California Hospital could treat about 1,250 patients a year -- far more than the 660 the county's Emergency Medical Services Agency had expected.
Officials aren't sure whether the numbers reflect a busy month or simply mean that there is an even greater need for trauma treatment in the central city area than they had thought. In any case, both the county and the hospital administrator are confident they can take on the extra patients. Despite the high numbers, the center has been able to treat all patients without filling up and without diverting ambulances.
One of the most severely injured patients the new trauma center has handled was 24-year-old Tamara Ruiz, whose liver was split into three pieces during a car crash Dec. 9. Ruiz, who works as a parking attendant at Hollywood Presbyterian Medical Center, said she was driving to work from North Hills at 6:30 a.m. when a car blindsided her car. She was not bleeding and had just a bruise above her right eye.
Paramedics took her to California Hospital, where a body scan revealed a lacerated liver and a fractured clavicle.
"The doctor said, 'Sign this paper,' and then he will make surgery," Ruiz said. "He said, 'Do you want me to tell you what I'm going to do?' I said, 'No, just save me.' " Then nurses and others ran with her gurney to the operating room.
Surgeons had to perform two operations because Ruiz was so weak. In the first surgery, Ruiz and relatives said, doctors had to staunch the bleeding; in the second, they finished stitching together her liver.
Claudia Margana, 30, flew from San Francisco to be at her sister's bedside. Ruiz flitted in an out of consciousness and seemed to have tubes all over her body. Margana said she kept asking for a pen and trying to write phone numbers, but Ruiz said she didn't remember any of that.
"They told us she might not make it," said Gabriela Sanchez, 28, who is married to Ruiz's cousin. "I just kept telling her she was fine and I love her. We kept praying."
On Friday night, a day and a half after the accident, Ruiz finally woke up and wondered what time it was, where she was and what had happened. By Saturday afternoon, doctors had removed the tubes and Ruiz could finally talk to her parents, who were anxiously waiting by the phone in El Salvador.
On Monday, she sat up, then walked a few tentative steps. She moved out of the intensive-care unit the next day and went home with Sanchez on Dec. 17. On Wednesday, she returned to the hospital for removal of a drain placed next to her liver to collect fluids.
"I just want to thank God for her and the doctors," Margana said.
At any given time, 16 people -- including a trauma surgeon, five nurses with different specialties, a respiratory therapist and trauma manager Steven Myles -- can immediately answer a "code trauma" call on the hospital's loudspeaker. The hospital also keeps a list of on-call doctors and brings them in when the primary doctor becomes busy.
About a week after opening, the trauma center had to call on this reserve list, beckoning a second surgeon, then a third, as two patients came in who required immediate operations, Myles said. One patient, with complex internal injuries from a car crash, required two surgeons. The other patient was a man who had fallen off a bicycle and impaled himself.
So far, the four trauma beds, two in each of two rooms in the corner of the emergency room closest to the ambulance parking lot, have not filled up with critical injuries at the same time.
On a recent Monday, hospital officials were using the area for emergency patients who were not seriously ill. Those patients would be moved if a trauma patient arrived.
The trauma rooms look very similar to other emergency rooms, with ventilators and heart monitors. But next to the beds, there are also newly purchased ultrasound machines, machines that warm blood or saline for rapid infusion, and wheeled carts carrying trays of specialized equipment for creating airways quickly or opening skulls.
One such tray held instruments for a thoracotomy, the opening of the chest. Among the 33 items inside this special metal box are bone shears, a saw for the sternum and a device that spreads ribs.