What to expect in the trauma ICU

A trauma intensive care unit (ICU) is often a place that families hope they will never have to visit, but are grateful for it when needed. ICUs are specially equipped units that provide highly specialized care to patients who suffer from a serious injury or illness.

As a family member or friend of someone with a traumatic injury, you may have many questions or worries about your loved one if a stay in a trauma ICU is required, but knowing what to expect might help ease some fears.

First, what is “trauma”?

Trauma (from the Greek word τραῦμα, meaning “wound”) also known as “injury”, is a physical wound (e.g., such as a fracture or broken bone ) caused by an outside source, such as a motor vehicle collision or fall.

According to the Centers for Disease Control (CDC), traumatic injuries are the leading cause of death for individuals between the ages of 1 year and 44 years in the United States.

According to Michael Foreman, MD, Medical Director on the medical staff of the Level I Trauma Center at Baylor University Medical Center at Dallas:

“Trauma is defined as a disease process that occurs after the application of energy. Our body has a remarkable ability to deal with forces that are applied to us—our skin is amazingly tough and we have strong muscles and bones that pad us and protect us from the outside world.”

“But any type of armor can be overcome. If it’s minor, just enough to injure a few cells, then you have the bruises and scrapes that we’re all familiar with. But at some point, the amount of force we absorb is more than the body can take. When hit hard enough, serious and life-threatening injury can potentially result. That’s where we come in.”

“Explore."

When you arrive at Baylor Dallas, it is important to know that you are in good hands, as it is one of only three adult Level I trauma centers in Dallas/Fort Worth, covering 21 counties (18,000 square miles) and 5 million lives.

In the United States, a hospital can receive trauma center verification by meeting specific criteria established by the American College of Surgeons (ACS) and passing a site review by the Verification Review Committee. A Level I trauma center provides the highest level of surgical care to trauma patients and has a full range of specialists and equipment available 24 hours a day.

Here at the Baylor Dallas Level I trauma center, a team of board-certified trauma surgeons, anesthesiologists and other specialists on the BUMC medical staff is available to provide rapid diagnosis and immediate treatment of life-threatening injuries. A variety of specialists are on-call to respond to the needs of trauma patients, including orthopedic-trauma surgeons, neurosurgeons, and other professionals.

Patients may be admitted to the trauma ICU from the emergency room, operating room or another floor of the hospital.

Once in the trauma ICU, specialized trauma attending physicians will be the primary group of doctors caring for your patient. During his or her stay, more X-rays, lab tests, operations, and other procedures may be needed. Patients also may have physical and occupational therapy while in the ICU. The patient will remain in the intensive care unit until he or she no longer needs 24-hour, intensive medical and nursing care.

It is important to know that your loved one may look and act very differently in the ICU. Swelling and bruises are common with traumatic injuries. Pain medication, head injuries, infection, and lack of sleep may make patients appear sleepy, restless or confused.

It is important to remember that although ICU patients may not be able to respond to a voice or touch, they may be able to hear and feel. When visiting your loved one, you should talk to them, hold their hand, and tell them they are loved.

Visiting hours in the trauma ICU are flexible, however there may be times when the trauma team will ask for you to wait outside the room. Guidelines for visiting patients can be obtained from your trauma nurse.

Various machines may be attached to patients. Some machines have alarms that go off without warning. These alarms tell the nurse to do different things, and are not always warnings of an unsafe situation. Sometimes, soft restraints may be used if your loved one is trying to remove the tubes, lines or drains.

You can expect the ICU staff to keep you informed of any major changes in the patient’s condition or procedures that are being performed. Patients in the ICU have a team that consists of many doctors, who make rounds throughout the day. Members of the ICU team routinely meet with the patient and family members to ensure everyone has a common understanding of the health condition and plan of care.

It will be necessary to appoint one designated person as the primary contact to receive and pass along new health status reports to others.

A team of clinicians from various disciplines together visit the patients’ bedside on Tuesdays and Thursdays at 10 a.m. (also called multidisciplinary rounds).

This may include doctors, nurses, people who work in nutrition, pharmacy, physical therapy, social work, and others, who will talk about the patient’s care and progress. Because family is an important part of the recovery process, we encourage you to attend these meetings as well.

In addition, support groups for the families of trauma patients are held every Tuesday on the 4th Floor of Roberts Hospital at Baylor Dallas at 11:30 a.m. Look for signs in the hallways for help in finding the room. Members of the trauma team will be available to answer questions and provide support. We strongly encourage all family members and friends of trauma patients to attend.

Therapy dogs from Baylor Health Care System’s Animal Assisted Therapy Program visit patients, family, and staff in the trauma department weekly. Therapy animals provide people with emotional support through the dog’s social instincts and skills.

You can download the Trauma Family Support Guide for more information during your loved one’s stay at Baylor University Medical Center and join the Level I Trauma Center’s Facebook group.

Life is unpredictable, know you can rely on Baylor Scott & White Health emergency care when you need us.

About the author

Megan Reynolds
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Megan Reynolds, MS, is the Clinical Research Coordinator for the Level I Trauma Center at Baylor’s flagship hospital in Dallas, Baylor University Medical Center. She is a native Texan and proud UNT Mean Green alum.

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What to expect in the trauma ICU