R Adams Cowley Shock Trauma Center

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R Adams Cowley Shock Trauma Center (also known simply as Shock Trauma or Shocktrauma) is a trauma center in Baltimore, Maryland. It was the first facility in the world to treat shock. Shock Trauma was founded by R Adams Cowley, who is considered the father of trauma medicine.

Early years

While serving in the United States Army in France immediatedly following World War II, Cowley found that many severe injuries could be stabilized if the patient could be transported to a military hospital, where a surgeon was present, within one hour of the initial injury. Dr. Cowley coined the phrase Golden Hour to describe this crucial period of time. Dr. Cowley lobbied the legislature in Maryland to purchase helicopters for the transport of trauma patients. When the Maryland legislature denied his request due the cost of helicopters, Dr. Cowley was able to convince the State of Maryland to purchase helicopters by agreeing to share them with the Maryland State Police. Today every major trauma center in the United States employs helicopters to transport trauma patients to the hospital.

During the early years of trauma center, R Adams Cowley fought with the medical community to change the policy of "nearest hospital first" which was prevalent at the time. In the early 1970s, first responders would take all patients to the nearest hospital emergency room. The flaw to this system was the nearest hospital was usually not capable of treating severe trauma. In 1975 a young prosecutor named Dutch Ruppersberger was involved in a near fatal automobile accident and his life was saved after being transported directly to Shock Trauma (not the nearest hospital). Mr. Ruppersberger ran for public office in part to advocate the trauma facility. The "nearest hospital first" was eventually abandoned and emergency medical systems across the United States now follow the model first advocated by Shock Trauma.


Shock Trauma houses over 100 inpatient beds dedicated to emergency surgery, resuscitation, intensive care, and acute surgical care. The facility boasts a dedicated resuscitation area in excess of 12 beds. The Trauma Resuscitation Unit (TRU) is located on the building's second floor. Helicopters and ambulances bring injured patients directly to the TRU for emergent treatment and stabilization. Specialized trauma teams composed of trauma surgeons, trauma fellows, surgical residents, emergency-medicine residents, students, nurses, and technicians stand ready to receive victims 24 hours a day, 365 days per year. The helipad at Shock Trauma can accommodate several medevac helicopters at a time and has direct elevator access to the resuscitation area several stories below.

Adjacent to the TRU is a vast array of equipment and facilities that are immediately available to the patient in extremis. Shock Trauma has six dedicated operating suites in addition to two multislice CT scanners, an angiography suite, and digital plain film capability. The inpatient wards of the Shock Trauma center consist of specialized intensive-care units, intermediate-care units, and regular surgical-floor beds. Intensive care at Shock Trauma is a multidisciplinary endeavor: the facility boasts dedicated beds for victims of multisystem and neurosurgical trauma.


Shock Trauma trains physicians and medical personnel from locations overseas and throughout the United States. The facility hosts emergency-medicine residents from the Johns Hopkins University and medical schools in Canada. Resident physicians from the department of emergency medicine at the University of Maryland are present on every trauma team. Shock Trauma receives over 7500 admissions per year and provides its residents with intensive training in the evaluation and management of both blunt and penetrating injury.

In May 2007, Dr. Thomas M. Scalea, physician-in-chief for the R Adams Cowley Shock Trauma Center, presented a case at the University of Maryland Medical School's annual historical clinicopathological conference in Baltimore on the assassination of President Lincoln and whether the world's first center for trauma victims could have improved the outcome had Lincoln's assassination occurred today. 'This could be a recoverable injury, with a reasonable expectation he would survive,' Scalea said, noting that the assassin's weapon was relatively impotent compared to the firepower now on the streets today.[1]

Shock Trauma's educational mission extends beyond the training of future physicians. The facility hosts members of the United States Armed Forces, in addition to providing education for local emergency-medical service providers.


External links

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