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Trauma, Surgical Critical Care, and Acute Care Surgery

Prisma Health Richland Hospital is an American College of Surgeons verified Level I Trauma Center. It is the only Level I Trauma Center in the Midlands, or the central portion of the state of South Carolina, and as such provides trauma care to a large segment of the state. The trauma center treats over 3500 patients each year.
Roughly 15% of the patients are victims of penetrating trauma (gunshot wounds or stab wounds), which is about twice the national average. The remainder of the patients suffer blunt trauma, consisting of mechanisms such as motor vehicle or motorcycle crashes as well as falls.  

Annually, approximately 600 patients are admitted to the Raymond P.H. Bynoe, MD, Surgical Trauma Unit, a brand new eighteen bed intensive care unit. The STICU is a state-of-the-art facility that enhances not only patient care but also helps support the families and friends of our patients. The unit is named after Dr. Bynoe, who was the hospital’s first trauma medical director and who continues to serve on the teaching faculty. 

The division of trauma is actively engaged in clinical research. A monthly meeting is held to assist with the production of high-quality research. Current areas of investigation include surgical nutrition, including volume-based feeding programs and the use of indirect calorimetry; cryoablation use in rib fixation; enoxaparin use after traumatic brain injury; dysphagia after tracheostomy. Additionally, a robust performance improvement program (PI) is led by two full-time PI coordinators. Active PI projects include improving the flow of patients out of the STICU as well as reducing any upgrades in care. 

The trauma division is highly invested in education as well as outreach in injury prevention. Advanced Trauma Life Support (ATLS) classes are run twice a year at our affiliated simulation center. Additionally, community efforts such as teaching bleeding control (BCon) courses and project READY (Read Education About Dying Young) are ongoing. Educational conferences are held weekly, and a quarterly multidisciplinary conference is held along with the departments of orthopedics and emergency medicine.  

Patient care remains the chief goal of our team, and, as Dr. Bynoe has said, the “100 hands of trauma” all play an invaluable role in the outcomes of our patients. In addition to our full-time trauma surgeons, the team consists of a critical-care fellow and a large complement of advanced practice providers (APPs) who specialize in trauma care. Specialized nurses, pharmacists, dieticians, therapists and social workers/case managers round out the provider team, while a robust staff of administrators, PI coordinators, registrars, and office staff provide endless support and guidance.  

Residents play a large and invaluable role within the division. They serve as chiefs on the trauma service, and as such coordinate the care of all our patients. They lead the necessary trauma surgeries and assists in running the STICU. Finally, they assist in leading the educational conferences.