Baylor expands trauma and emergency care center

While high costs and staffing difficulties are prompting many hospitals across the country to close down their trauma centers, Baylor University Medical Center at Dallas is moving in a different direction. In January, Baylor Dallas will complete a $47 million expansion of its emergency department, adding to its Level I trauma capabilities. The emergency department will be more than 70,000 square feet with 85 patient care rooms that will include a separate area for a physician referral center and expansion of the minor emergency care clinic.

“A trauma hospital is a specialty hospital inside a hospital,” says Michael Foreman, MD, medical director of the trauma/surgical ICU and a trauma surgeon on the medical staff at Baylor University Medical Center at Dallas.

“We need to take care of everybody that comes through the door … and we have specialists and sub-specialists to call on when we need them.”

The medical staff at Baylor Dallas will also expand with the addition of two trauma surgeons, bringing the total to nine general and orthopaedic specialists devoted to trauma. These surgeons will join a medical staff of neurosurgeons, anesthesiologists and a wide spectrum of other specialists and sub-specialists from the hospital who are available around the clock to quickly assess and treat patients. Having such depth and expertise in the staff leads to better care, Foreman says.


“You don’t need retina specialists — or podiatry specialists or a renal specialist — every day. But knowing we have the ability to bring them in immediately makes us all more comfortable,” he says. “The specialists available here are just incredible. Their availability allows us to do more things for the patient than you can typically do anywhere else.”

Foreman arrived at Baylor Dallas in 1987 as the hospital’s first trauma surgeon and helped the hospital obtain Level I designation, received in 1989. Baylor Dallas is one of only two adult Level I hospitals in North Texas, handling 40% of the serious trauma cases in the area.

As many as 39% of trauma patients who come to Baylor’s emergency room are uninsured, according to Foreman. While some hospitals get public funding for the uninsured, Baylor Dallas does not receive any county tax dollars to support its trauma and emergency center.

“It’s truly a service to the community,” says Foreman. Baylor Dallas serves 3,000 major trauma patients a year, providing critical care management in an efficient system. The planning for those emergency patients, who come at all hours and show a wide range of trauma, often occurs before they arrive, says Alan Jones, MD, an orthopaedic trauma surgeon on the medical staff at Baylor University Medical Center at Dallas.

“The trauma team is activated before you get here,” Jones says. “Things happen very quickly after a patient arrives.”

Neil Moore of Frisco knows firsthand how the experience at Baylor’s trauma center can change a person’s life.

In August 2005, a large truck came into his lane of traffic at a high rate of speed and struck his car head on. After a grueling 20 minutes for emergency personnel to cut Moore out of his car, he was transported by CareFlite® to Baylor Dallas and labeled as an amputee patient because his leg was just inches away from being completely severed.

That night the team at Baylor Dallas went to work in a four-hour surgery that saved Moore’s leg. After a week in the intensive care unit, Moore was released to the rehabilitation center for physical therapy for his leg, shoulder and head injuries.

“I felt so comfortable with every aspect of my care at Baylor,” Moore says.

Back at work full-time now as a salesman for Microsoft, Moore says his mobility is a necessity to his job.

“My life would have been completely different as an amputee,” he says. “I would have been on disability and then had to find a new job. The orthopaedic trauma team saved my leg and kept that from happening.”

Once in the trauma center, the patient is assessed by a team of physicians, emergency care and trauma nurses, X-ray technicians and other health care specialists using advanced CT scanners and other technology, such as the patient cooling and warming systems, and high frequency oscillator/ventilators. Team members communicate with each other, using ongoing dialogue to determine the best course of treatment, Jones said.


Patients who need surgery can be in an operating room within minutes of their arrival. This level of care helps to treat more patients within the “golden hour,” which often results in a better outcome.

“The sooner you take this type of patient to the operating room, the better it is for him or her,” Jones says. “And here we have an operating room whenever we need it.”

Once inside Baylor Dallas, trauma patients are connected to a continuum of care that includes a dedicated special intensive care unit and inpatient unit, special wound care center, a limb salvage program, a neuroscience center, and an inpatient rehabilitation center.

“Discharge and therapy planning occur almost from the time of admission,” Foreman says.

To continue care after leaving the trauma center, patients may go to the Baylor Institute for Rehabilitation (BIR), a 116-bed on-campus facility. The hospital has been recognized to be among the nation’s top rehabilitation facilities for 11 years and was ranked 15th this year by U.S. News & World Report.

“It’s a jewel in our crown,” Foreman says. “BIR supports our entire infrastructure.”

In addition to comprehensive inpatient services, outpatient specialty programs and clinics, BIR has expertise in recovery programs for patients with traumatic brain and spinal cord injuries.

Baylor Dallas also provides specialized service at its Comprehensive Wound Care Center. Among advanced treatments available to aid healing are hyperbaric oxygen therapy, Doppler evaluation, transcutaneous oxygen monitoring and negative pressure therapy. The center also supports a limb salvage program for treating complete or partial severance of limbs, crushed bones and multiple fractures.

At the Baylor Neuroscience Center, the full range of neurological disorders and injuries are treated including brain tumors, strokes, aneurysms, head trauma and spinal cord injuries.

Long after a trauma patient has been discharged from any center or department at Baylor Dallas, the hospital trauma staff continues pushing for high quality of care and best practices. Staff members communicate about each case through a weekly trauma case review committee and trauma conference as well as a monthly multidisciplinary trauma peer review committee.

While one in three Americans will require trauma or injury care in their lifetime, Jones and Foreman say most trauma is avoidable by taking simple safety precautions. Wearing seat belts in vehicles and helmets on bikes or motorcycles as well as avoiding cell phone calls — and texting — while driving are among the measures they recommend.

The physicians say the No. 1 way to avoid a trip to the emergency or trauma center, however, is to avoid drinking alcohol or taking drugs before or while driving.

“There are very few real accidents,” Jones says. “Most people contribute to their injuries in one way or another.”  : :

More information about Baylor's trauma programs. Find a physician on the medical staff at Baylor by using our on-line physician directory or call 1-800-4BAYLOR.