UC Davis Medical Center's trauma program is widely regarded as a national leader. Behind that distinction are the tireless efforts of UC Davis experts who play leading roles in developing trauma-prevention legislation, enhancing nursepractitioner regulations and setting standards for trauma care.
Roxanne Woods, coordinator of UC Davis' Trauma Outreach and Prevention Program, helped secure adoption of California's Child Restraint Law. The law requires children to be properly secured in a vehicle's back seat until they are at least 6 years old or weigh at least 60 pounds.
Emergency room personnel at the medical center were convinced of the benefits of child-booster seats since the leading cause of children admitted to the trauma unit for injuries was motor vehicle collisions. Woods crafted language for the law and provided testimony to legislative committees with data about the types of injuries treated at the medical center, and the cost to the state in injuries and fatalities. She also secured trauma surgeons to testify as expert witnesses.
"Presenting the data helps us to pass laws that improve safety and public health," she says.
Woods also worked closely with legislators to pass the 2003 state law requiring children under age 18 to wear a helmet while skateboarding, scootering and in-line blading. The helmets the law requires are key to preventing head and brain injuries among children.
As a member of the California Coalition for Children's Safety and Health, Woods testified in favor of legislation signed into law in September requiring owners of older residential swimming pools to add a child-safety device when remodeling. The new law bolsters an existing 1998 state law requiring at least one child-safety device, such as a pool alarm or fence, on all newly built pools.
"To have such credible testimony from UC Davis experts is very powerful in the Legislature," says Judy Barrett Miller, executive director of the coalition. "We rely on them for their medical expertise and to get all the facts out. The dedication to preventing trauma runs deep throughout the whole staff."
Trauma nurse practitioner Robert O'Malley, who has been with the trauma program since 1995, worked with the California Association for Nurse Practitioners to pass a state law allowing nurse practitioners and physicians assistants to furnish Schedule II pain medications to patients. The group was founded in 1977 by nurse practitioners from UC Davis.
"The change has made a great practical difference for us," O'Malley says. "Relieving patients' pain is a big part of what we do and before the law, trauma nurse practitioners were prevented from making available to trauma patients some of the more effective drugs. Now we're able to use the optimal medicines – what the patients truly need to manage their pain."
Setting standards of care
Trauma surgeon and professor David Wisner contributes to many of the national standards of care recommended by the American College of Surgeons for the treatment of traumatic injuries, as well as to national guidelines, such as dictating staffing levels and physician response times designed to optimize trauma care in the United States.
Wisner also shared his expertise with Mercy San Juan Medical Center in Carmichael for two years when that hospital established a Level II trauma center in 1999. Patients benefited as the hospital added specialty doctors and enhanced laboratory and imaging services to provide the 24-hour services necessary for a Level II trauma program.
Leon Owens, trauma care director at Mercy San Juan, says Wisner wanted the neighboring trauma center "to stand on its own."
"He got us up and running, then turned over the reins to us. He set the high standard of care here... He remains the person I call when I have a problem, because the whole level of trauma care in the greater Sacramento region is influenced by him and is excellent by virtue of him," Owens says.
Improving care region-wide
Wisner continues to discover and share the advanced knowledge required to improve trauma care regionally and nationally. He and others on the UC Davis trauma team meet quarterly with medical staffs from the other trauma care centers in the six-county region – Mercy San Juan, Sutter Roseville and Rideout Hospital in Marysville – to discuss specific trauma cases in order to evaluate how to improve care for all trauma patients and the quality of health care for all.
UC Davis' role "has been absolutely paramount in getting these trauma centers up and running throughout the whole region," says Leonard Inch, regional executive director of the Sierra-Sacramento Valley Emergency Medical Services Agency, the regional EMS agency for Placer, Yolo, Nevada, Sutter and Yuba counties. "The staff knows everything cutting-edge in trauma care and this spurs on the other trauma centers to excellence in research and care."