F E A T U R E : T R A U M A

What do you do when doctors insist your son will die without a blood transfusion – which violates his religious beliefs and severs you from your spiritual community?

Art and Liz Still, Jehovah’s Witnesses from Liberty, Mo., turned to The University of Kansas Hospital, the region’s only nationally verified Level I Trauma Center. Using the latest blood conservation practices, the trauma team can perform lifesaving procedures to accommodate the wishes of patients who refuse blood transfusions.

In September 2010, Luka Still, then 22, suffered massive injuries in a high-speed motorcycle crash. He had severe traumatic brain injuries, countless broken bones and damage to internal organs. Doctors at an area hospital told Luka’s parents he needed a blood transfusion to survive. Their religion rejects the procedure.

A retired Kansas City Chiefs defensive end, Art thought he could take a crushing blow. But nothing prepared him for the weighty decision before them. He and Liz refused the transfusion and began seeking alternatives.

Blood management expert“Elora Thorpe was the real catalyst in our

decision to transfer Luka,” Art said. “She’s a national authority on blood conservation and has been very helpful to our religious community.” Thorpe, an RN, is the hospital’s transfusion safety nurse manager. Two days after the accident, Luka arrived at the trauma center clinging to life, dangerously anemic from blood loss.

“He was as close to brain dead as he could possibly be,” said Michael Moncure, MD, Trauma and Critical Care director. “But it’s not our job to try to convince patients or families to go against personal beliefs. We develop a strategy to support their wishes.”

Initiative improves outcomesThe trauma team had adopted blood

conservation practices months earlier when

the hospital launched the state’s first blood management initiative. Collaborating closely with neurosurgeon Jules Nazzaro, MD, orthopedic surgeons and other specialists, the team mapped out a coordinated approach to address Luka’s complex injuries. They delayed surgery for about two weeks to rebuild his blood supply and improve his condition.

For five weeks, Luka remained unconscious in intensive care. His family – he is the fifth of 11 children – showered him with love. After he awakened and left ICU, he spent another month on a recovery unit.

“The whole team was just wonderful,” Liz said. “Not only doctors and nurses, but everyone we had contact with. And no one ever mentioned a blood transfusion.”

Progress measured in yearsWith severe traumatic brain injuries,

progress is measured in years. Within six months, Luka began remembering who he was and recognized his parents. Through continued physical and speech therapy, exercise, a careful diet and determination, he has become increasingly self-sufficient. He lives with his family and takes care of himself. He walks slowly with a cane, makes witty conversation and structures his time in online research, reading and listening to music.

“I’m really thankful for everything the hospital did for me and for my family,” Luka said.

Trauma team respects wishes to forego blood transfusionsBlood conservation techniques help accommodate trauma patients’ religious beliefs

Saving blood saves livesIn 2010, The University of

Kansas Hospital launched the state’s first blood management initiative. Research indicates patient outcomes improve when blood products are used only when absolutely necessary.

Results over four years:• Reduced patient exposure to

blood products by 58 percent (adjusted for hospital’s increase in patient volume and in severity of conditions treated)

• Reduced complications and lengths of stay

• Saved patients more than $12 million

To learn more, visit kumed.edu/SavingBlood.

As Jehovah’s Witnesses, Art and Liz Still and son Luka reject blood transfusions on religious grounds. The trauma team at The University of Kansas Hospital used blood conservation practices to save Luka’s life without a blood transfusion when he was critically injured in a motorcycle accident in 2010.

Whenever a national leader visits Kansas City, The University of Kansas Hospital’s Trauma and Critical Care director Michael Moncure, MD, is consulted well in advance.

As the region’s only nationally verified Level I Trauma Center, the hospital often goes on standby when top-level elected officials and government dignitaries make stops throughout the metro area. The hospital is also the official injury treatment and healthcare provider for Kansas Speedway, the Kansas City Royals and the Kansas City Chiefs.

The trauma center treated and cared for a record 2,163 patients in 2013 – 1,761 for trauma and 402 for burns. The hospital’s Gene and Barbara Burnett Burn Center is the region’s only adult and pediatric burn care facility accredited by the American Burn Association.

“The top national verification puts our trauma program among the best in the country,” Moncure said. “We are prepared around the clock to handle the full range of trauma incidents – everything from multi-vehicle traffic accidents to violent crimes to mass casualty emergencies such as explosions and natural disasters.”

Highest standard of careSpecifically, the Level I distinction

recognizes the trauma center’s ability to provide the highest possible standard of care

for the most severely injured patients and those with complex, multisystem injuries. The program is the region’s largest; the trauma center treats nearly twice as many patients each year as the next largest facility.

The multidisciplinary trauma team’s 38 physician specialists include trauma surgeons, emergency medicine physicians, neurosurgeons, orthopedic traumatologists and orthopedists, plastic surgeons, radiologists, pediatric critical care specialists and others. Trauma nurses, therapists, nutritionists, neuropsychologists, case managers, care coordinators and others round out the team.

Learn more at kumed.edu/trauma.

Trauma Center ranks among best in U.S.Region’s only nationally verified Level I Trauma Center cares for record 2,163 trauma and burn patients in 2013

Our Trauma Center by the numbers

2,163 Trauma and burn patients treated in 2013 – a record

number for the center

100 Approximate number of hospitals transferring trauma patients in 2013

26 States trauma patients were transferred from

38 Multidisciplinary physician specialists on the trauma team

7.7 Percentage of U.S. trauma centers that are currently nationally verified as Level I

by the American College of Surgeons

14 Continuous years the hospital has been nationally verified as a Level I Trauma Center

Level I trauma care: A crucial difference

Life can change in an instant if you or a loved one suddenly suffers a severe injury or a dire medical emergency.

Rushing to the nearest hospital is a common reaction, but trauma centers are not all the same. In fact, more than 90 percent of U.S. trauma centers lack the on-site multidisciplinary trauma surgeons, critical care physician specialists and other resources the American College of Surgeons (ACS) deems necessary to provide optimal care to injured patients. These facilities often must transfer trauma patients elsewhere – as precious minutes tick by.

Only Level I Trauma Centers nationally verified by the ACS possess the resources and capabilities to provide total care for every aspect of injury, from prevention through rehabilitation. Trauma facilities rank from Level I to Level IV.

The University of Kansas Hospital is the region’s only ACS nationally verified Level I Trauma Center; the next closest Level I facility in Kansas is nearly 200 miles away. Fewer than 8 percent of U.S. trauma centers currently hold this distinction. The hospital received ASC’s top verification in 2000 and has held it continuously ever since.

A D V A N C I N G T H E P O W E R O F M E D I C I N E ®

Level I Trauma Center team members (from left) Alexsis Johnson, RN; Travis Pollema, DO; Tammy Murray, RN; and Jeanette Addington, RN, are among staff who respond to more than 1,700 traumas each year at The University of Kansas Hospital.