Raymond Georgen, M.D. is the Director of Trauma At Theda Clark Medical Center since the inception of the trauma program in 1990.  He is responsible for developing the system with trauma alert criteria, a multi-department response team and a systematic approach to caring for the traumatized patient and their families from admission through discharge.  Dr. Georgen has a private practice of general/vascular surgery in Neenah.

Dr. Georgen is board certified in general surgery.  He is a graduate of Loyola University Stritch School of Medicine completing his residency training in general surgery at Loyola University Medical Center in Maywood, Illinois.  He is a member of the Wisconsin State Trauma Advisory Council (STAC).

Kelly Jung has been the Trauma Coordinator at Theda Clark since May of 1996. She  graduated with a Bachelor’s Degree in Nursing from the University of Wisconsin – Eau Claire and is currently working on her Master's degree through Silver Lake College. Kelly practiced as a trauma nurse in Illinois for a Level 1 Trauma Center for two years. These initial experiences cultivated a love for working in the world of trauma. She has had many roles and responsibilities caring for trauma patients and their families in the ED and critical care units over the years. Kelly has been actively involved for the last few years with the development of the State Trauma Plan and Regional Trauma Advisory Council (RTAC) activities.

The Trauma Coordinator can wear many different hats depending on the needs of the hospital and trauma program. The Trauma Coordinator is responsible to coordinate, plan, develop and maintain all services/systems required for an organized, multi-disciplinary approach to caring for the trauma patient. The Trauma Nurse Coordinator is a registered nurse who works closely with the hospital medical staff, administration, department heads, ancillary services, nursing personnel, EMS agencies, community hospitals and law enforcement agencies to coordinate all aspects of trauma care.

A "typical" day for the Trauma Coordinator at Theda Clark can include:
• Monitoring the care of patients admitted to Trauma Services
• Trauma education to hospital staff including trauma orientation in the ED
• Trauma case study presentations and clinical or equipment updates based on identified needs
• Outreach activities in the community to EMS services and referring hospitals including follow-up information regarding referrals
• Providing direct clinical care to incoming trauma patients in the ED
• Problem solving related to the care of trauma patients
• Reviewing and updating equipment and policy/procedures daily
• Financial planning and accountability for the trauma program
• Attending numerous hospital and community meetings representing the trauma program
• Reviewing and revising trauma protocols
• Assisting the injury prevention coordinator with community activities
• Developing and monitoring quality improvement issues and initiatives
• Participating in state and regional trauma system development
• In other words, acting as the glue that keeps the trauma program together and running on a daily basis

A copy of Kelly’s job description is available upon request.

The Trauma Registry is a critical link between local trauma data collection and the national trauma data bank. Information compiled not only meets the requirements of the American College of Surgeons(ACS) to be a Verified Level II Trauma Center, but more importantly, leads to improvements in trauma care quality across the nation.

Susie Arter is currently the Trauma Registrar.  Duties involve data collection of all Trauma Blue, Trauma Consults and traumatic injuries seen at Theda Clark Medical Center using the National Tracs database through the (ACS). Yearly, data elements are sent to the National Trauma Data Bank at the ACS for participation in national trauma statistics. performance improvement/quality assurance issues are followed and discussed at monthly Trauma Committee meetings. These quality issues are then followed through with the appropriate individuals and/or groups to improve the overall trauma program. complications and quality indicators as recognized through the ACS are monitored, trended and discussed at Trauma Committee meetings as needed. Meticulous care is taken to provide privacy and confidentiality to all patients placed in the Trauma Registry in adherence with the HIPPA regulations.

Trauma Scores and Scales
The following contains basic information on different types of scoring and scaling systems used with trauma. More detailed information can be found in books, trauma journals and internet sites.  When an injury is categorized with a scaling or scoring system it is grouped into two different types.
1) scales which assess the patient’s physiological status, changing over time and
2) those which describe the injury in terms of its anatomical location, specific lesion and relative severity, staying a constant value.  

Abbreviated Injury Scale (AIS) and the Injury Severity Score (ISS)
The Abbreviated Injury Scale (AIS) ranks traumatic injuries in terms of the anatomical location and severity of the injury. Each traumatic injury is assigned a 7 digit number, with the last number representing the severity of the injury to be used in tabulating the Injury Severity Score (ISS). AIS numbers can be found in The Abbreviated Injury Scale Dictionary disturbed by the Association for the Advancement of Automotive Medicine.
• AIS Code Example: Brain Stem Contusion 140204.5 The ISS is also an anatomical scoring system, but only recognizes the highest AIS in each of the six body regions (Head, Face, Chest, Abdomen, Extremities, and External). The ISS is used to assess survivability and often compared with bench marks in areas as ISS vs. length of stay, ISS and mortality, etc. Only the highest AIS score in each body region is used, the three most severely injured body regions have their scores squared and added together to produce the ISS. An ISS score ranges from 0 to 75, any un-survivable injury is assigned an AIS of 6 which will automatically assign a score of 75.

Glasgow Coma Score (GCS)
The GCS is a score used for evaluating the patient's level of consciousness using their best eye-opening, verbal and motor response to stimuli. Scores range form 3-15 with the lower scores indicating decreasing levels of consciousness and/or coma.

Things to remember when scoring the GCS:
• The score is assessing the patient’s BEST response so it is important to note any disabilities or the patient’s base line prior to the trauma if possible.
• Attempt to obtain information on the patient’s cognitive abilities prior to the incident.
• With any patient that appears awake and somewhat alert, but has a low GCS, check other factors: is there a language barrier, are they hard of hearing, has a child been told not to talk to strangers, etc.
• Medication Effects GCS-Always note any medications that may effect the GCS-sedatives, paralytics, alcohol
• A patient on paralytics will have a GCS of 3, but it needs to be noted that a paralytic has been given
• Documenting GCS=8 is of little help, each eye, verbal and motor response needs to be documented. E=2, V=2, M=4
• Remember 3 is the lowest GCS score there is, deceased patients have a GCS of 3
• If any patient is too young or cognitively unable to follow commands use a Pediatric Coma Score

Revised Trauma Score
The Revised Trauma Score is a physiological scoring system that is used for triage, predicting mortality and probability of survival. It is based on the patient’s Respiratory Rate, Systolic Blood Pressure and Glasgow Coma Scale with each variable assigned a value of 0-4. Score totals range from 0-12, with higher RTS indicating a better prognoses and lower score with poorer prognoses and higher mortality. The ACS suggests that a patient with a RTS < 11 should be triaged to a Trauma Center.

The goal of the Trauma Center's Injury Prevention program is to reduce the number of unintentional injuries and deaths in our community and referral area through a comprehensive and collaborative approach implementing injury prevention strategies and program implementation and evaluation.

Sharon is the Injury Prevention Coordinator for Trauma Services at Theda Clark. Sharon graduated from Fox Valley Technical College in 1985 with an Associate Degree in Nursing and in 2002, graduated from UW Green Bay with a Bachelors of Science in Nursing. She is attending graduate school at Silver Lake College. She has extensive emergency and critical care nursing, public speaking, computer skills and research expertise that enable her to perform the variety of responsibilities necessary in coordinating aspects of injury prevention care.

ENCARE/ Emergency Nurses Care  and "PARTY"
Target audience: Teens
Program content: Information about the consequences of risky behaviors such as seat belt non-compliance, drinking and driving, underage drinking.

Safe Seniors
Target audience: Adults 65 and older
Program Content: Emphasis on the leading causes of unintentional injury among seniors with methods to prevent them.

THINKFIRST
Target audience: Children 1st to 4th grade
Program Content: Emphasis on preventing brain and spinal cord injuries –helmet promotion.

Touchpoint/ThedaCare Bike In-line Skate Rodeo
Target audience: Children grades K-4 and their parents
Program Content: Promoting safe biking/skating through demonstration and free helmet distribution.  

Recreational Sports Injury Prevention Series
Target audience: Children age 12 to adult seeking certification through DNR State certification courses.
Program content: Injury prevention and first aide information specific to course certification. 
Presentations include: Hunting Boating ATV Snowmobile