Palomar Medical Center Escondido’s Trauma Team

Saving Lives Every Day

“When you work in trauma care, you have to be ready at a moment’s notice to give rapid, focused care to multiple, life threatening injuries,” says John Steele, M.D., Medical Director of Palomar Medical Center Escondido’s Trauma Center.

The nature of trauma is that it is unexpected – and largely preventable, according to Dr. Steele who is a board-certified trauma surgeon. A traumatic event occurs every four seconds nationwide and is the leading cause of death among Americans under 44 years of age.

Palomar Medical Center Escondido is one of six designated trauma hospitals in San Diego County’s coordinated trauma system, which is considered a premier model throughout the country. Palomar Medical Center Escondido’s 2,204 square-mile trauma service area has more than 540,000 residents and reaches from southern Riverside County to Scripps Ranch and the Anza Borrego Desert to the coast. Covering this diverse area means treating a broad range of traumatic injuries treated.

“We’ve seen it all and have taken care of all sorts of massive injuries,” Dr. Steele says. “We do save lives everyday.”

Last year, nearly 1,200 patients were treated at Palomar Medical Center Escondido’s Trauma Center, arriving by helicopter or ambulance. Approximately 93 percent of the patients are treated for blunt force injuries from automobile, motorcycle and recreational vehicle collisions. One-quarter of the patients had positive blood alcohol levels and 30 percent were under 26 years old. Nearly one-third of all trauma patients required surgery to repair injuries.

“Trauma is a surgical specialty, whereas emergency medicine is a medical specialty,” says Debra Byrnes, B.S.N., Trauma Program Director. “Trauma results from outside forces while most emergency situations, such as a heart attack, are the result of a medical condition.”

Of growing concern, is the increasing number of elderly patients suffering severe head injuries from falling in their home. Last year, 125 patients over age 65 were treated at Palomar Medical Center Escondido’s Trauma Center for this reason.

“If they are taking blood thinners, extensive internal bleeding may result, turning a common fall into a serious traumatic event,” Dr. Steele says. “We are concerned about this trend and have started community outreach to inform elderly patients how to prevent falls.”

Trauma Resuscitation Team

As a Level II Trauma Center, Palomar Medical Center Escondido must be staffed for immediate response. This requires having a trauma surgeon on site 24/7, with a backup trauma surgeon available if multiple trauma victims arrive simultaneously.

“First responders in the field activate the trauma response system, so our team is assembled even before the patient arrives. That way, we save precious time and can start evaluation and treatment rapidly,” says Dr. Steele.

The Trauma Resuscitation Team includes the trauma surgeon, emergency physician, trauma nurse team leader, rapid response nurse, operating room nurse, trauma technician, chaplain and security staff. On call specialists are also promptly available.

“As a trauma hospital, Palomar Medical Center Escondido has specialists in every area, which elevates the standard of care hospital-wide, from surgery to radiology and from the lab to inpatient care units,” Dr. Steele says.

Advances in Trauma Care

“The CT (computed tomography) scanner is the best diagnostic tool we have because it provides very detailed, sequenced images of organs and bones to help us define the extent of internal injuries very quickly and accurately,” Dr. Steele says.

Another advancement credited with saving lives is the rapid infuser.

“The rapid infuser is making a huge difference in our ability to stabilize critically injured patients who have lost a large volume of blood,” says Carol Gamble, R.N., Trauma Team Nurse Leader. “It delivers a liter of blood products, warmed to body temperature, within two minutes.”

Trauma: A Preventable Condition

“Prevention is the most effective way to treat trauma,” Dr. Steele says. “Most injuries are the result of poor choices, such as drinking and driving or not wearing protective gear when riding a motorcycle or ATV.”

Palomar Medical Center Escondido recently partnered with Poway High School, the Poway Fire Department and San Diego County Sheriff’s Department to present an outreach program, “Every 15 Minutes,” which informs high school students of the dangers of drinking and driving. The key message was that every 15 minutes someone in this country is seriously injured or dies from an accident involving alcohol.

“I hope our education efforts make students realize that sometimes poor choices result in irrevocable consequences,” Dr. Steele says.

Despite such outreach efforts, the number of trauma cases continues to climb as San Diego County’s population grows. From 1985, when the countywide trauma system was established, to 2005, the number of trauma cases doubled, from 4,374 to 9,984. The good news – during that same time, the preventable death rate from major traumatic injury has fallen from 21 percent to less than one percent.

“We consistently strive to do better by evaluating our work internally and as part of the countywide trauma system,” says Byrnes. “By sharing data, we learn how to improve our standard of care, prevent complications and improve survival. We are proud of our work because we are saving lives every day and that makes difference for our community.”

If this story inspired you, give now to the Palomar Health Foundation to help other patients. Contact us at 760.739.2787 to discuss any gift opportunities.

  • Palomar Medical Center Escondido


    2185 Citracado Parkway

    Escondido, CA 92029





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    15615 Pomerado Road

    Poway, CA 92064