2016 Childress Institute for Pediatric Trauma Annual Report

2016 STATE OF THE INSTITUTE REPORT

The Childress Family Commitment The Childress Institute for Pediatric Trauma has worked diligently to save the lives of injured kids since July 2008. With eight years of progress under their superhero belts, Richard and Judy Childress can see their vision is coming true.

As they hoped, the Childress Institute has become the focal point of a national movement to improve the level of pediatric trauma care available across the country.

The Childress commitment is more than financial. The Childress and Dillon families help us throughout the year to raise funds and awareness for research, education and advocacy initiatives to save injured kids.

The 2016 report shows how their legacy lives and grows, just like the injured children they strive to save.

OUR MISSION: Richard and Judy Childress, Guardians of the Pediatric Trauma Galaxy

WE DISCOVER AND SHARE THE BEST WAYS TO PREVENT AND TREAT SEVERE INJURIES IN CHILDREN.

From the Executive Director The Childress Institute for Pediatric Trauma knows many superheroes. They come in all shapes and sizes and help us fulfill and share our mission. Throughout these pages you will see heroes that save kids’ lives with their behind-the-scenes research, hands-on teaching and caregiving, and proactive advocacy, as well as the smallest heroes that touch our lives with their pediatric trauma stories.

We achieved major milestones in 2016 thanks to the support of our national collaborators. We are beginning to see results from our two Childress Summits with published papers and the launch of several national research programs. Our continued support of two important studies allowed for new phases of their work.

We took key learnings from 2015 and expanded our golden hour education initiatives with programs that will grow further in 2017, with a focus on providing low-cost or free education for EMS, athletic trainers and other first responders. We continue to test ideas in our backyard that we can scale and grow to other parts of the U.S. After years of work in Washington, we are finally able to say there is a Pediatric Trauma Caucus in Congress. This is monumental for our cause to gain recognition on a national scale. We look forward to positive strides in 2017 to increase our reach.

This report has a new look that we hope reflects our passion and mission. You can help save injured kids by supporting our events, buying items from our store and auctions, or funding one of our programs. Visit SaveInjuredKids.org or find us on social media to learn more about our mission, programs and sponsorship opportunities.

Thanks for your continued support! Stay inspired!

Bob Gfeller

Bob Gfeller, Executive Director aka Captain Inspiration

1

GROWING OUR IMPACT THROUGH THE YEARS TERI rural needs assessment

Seattle, WA – University of Washington

WA

Rep. Greg Walden

OR

Honolulu, HI – Tripler Army Medical Center in Hawaii

Milwaukee, WI – Children’s Hospital of Wisconsin

MT

TERI rural needs assessment

HI Salt Lake City, UT – University of Utah

WI

Rep. Fred Upton

MI

Cincinnati, OH – Cincinnati Children’s Hospital Medical Center and Nationwide Children’s Hospital

OH

Indianapolis, IN – Riley Children’s Hospital

IN

UT

TERI rural needs assessment Louisville, KY – Kosair Children’s Hospital

Las Vegas, NV – EMS World Expo

KY

Clever, MO – EMS World Scholarship winner

NV

Los Angeles, CA – Children’s Hospital of LA and UCLA Sacramento, CA– University of California, Davis School of Medicine

IA

Rep. Billy Long

CA

MO

Rep. P

Birmingham, AL – Children’s Hospita Phoenix, AZ – Phoenix Children’s Hospital Rep. Ruben Gallego, Rep. Trent Franks

Research Collaborators Education Programs

Advocacy: Pediatric Trauma Caucus Members

2

AZ

Dallas, TX – UT Southwestern Fort Worth, TX – Cook Children’s Medical Center Austin, TX– Dell Children’s Medical Center San Antonio, TX– San Antonio Military Medical Center Houston, TX– Texas Children’s Hospital TERI rural needs assessment

TX New Orleans, LA – EMS World Expo Rep. Ralph Abraham

LA

Queens, NY – Cohen Children’s Medical Center of New York New York, NY – Columbia University, Harlem Hospital Center

Pittsburgh, PA – Children’s Hospital of Pittsburgh of UPMC Philadelphia, PA – Philadelphia Pediatric Medical Device Consortium

PA

Rep. Tom Marino and Rep. Charlie Dent

MA

Boston, MA – Boston Children’s, Harvard Medical School and Tufts University School of Medicine

MD

Baltimore, MD – Johns Hopkins Bloomberg School of Public Health and Uniformed Services University of the Health Sciences

DC

American College of Surgeons CDC Emergency Medical Services for Children National Resource Center Eunice Kennedy Shriver National Institute of Child Health & Human Development Maternal Child Health Bureau / Health Resources and Services Administration Children’s National Medical Center National Association of Emergency Medical Technicians National Highway Traffic Safety Administration We participated in the launch of the Pediatric Trauma Caucus.

Special thanks to all members of Congress that have joined.

Encourage your representatives to join.

VA

Rep. Phil Roe

TN

ospital of Alabama

o

NY

Rep. Tom Reed

Blacksburg, VA – Virginia Tech Richmond, VA – Children’s Hospital of Richmond at VCU

Chapel Hill, NC – University of North Carolina Durham, NC – 410 Medical Winston-Salem, NC – Wake Forest University and Wake Forest Baptist Medical Center

AL

NC

Greenville, NC – Vidant Medical Charlotte, NC – Carolinas HealthCare System Rep. Richard Hudson, Rep. G.K. Butterfield, Rep. Virginia Foxx, Rep. Robert Pittenger

FL LA

Atlanta, GA – ABOM class

Jacksonville, FL – UF & Shands Jacksonsville West Palm, FL – St. Mary’s Medical Center Homestead, FL – Homestead Hospital

GA

3

RESEARCH Childress Summit Update

The Journal of Trauma and Acute Care Surgery published the paper “Proceedings of the second Childress Summit on pediatric trauma: Operationalizing the vision” in its October 2016 edition. The paper was co-written by Dr. Mary Fallat with Kosair Children’s Hospital, Dr. Barbara Gaines with Children’s Hospital of Pittsburgh of UPMC, Kathy Haley with Nationwide Children’s Hospital, Dr. J. Wayne Meredith with Wake Forest Baptist Medical Center, Dr. David Mooney with Boston Children’s Hospital, and Dr. Jeffrey Upperman with Children’s Hospital of Los Angeles, as well as contributions from the Childress Summit II work groups.

The proceedings paper laid out the results from the summit, including plans for: • •

Our heroes on the front lines help us determine how to save more injured kids. Pictured: Angela Mickalide, PhD, (EMSC) and Mary Fallat, MD (Kosair Children’s Hospital).

•

A virtual pediatric trauma network – mobile data for both parents and providers A pediatric trauma toolkit – up-to-date, easily accessible pediatric trauma information for practitioners who infrequently encounter these patients, which could bring pediatric trauma expertise to the bedside of all injured children A “dashboard” to measure pediatric trauma care and provide consistent and thorough information to improve clinical care throughout the U.S.

Pediatric Trauma Device

We partnered with the Philadelphia Pediatric Medical Device Consortium to launch our first pediatric trauma device grant in 2016. The grant was awarded to 410 Medical, founded by Dr. Mark Piehl, which received $50,000 for the LifeFlow®, a simple hand-operated rapid infusion device. Since rapid delivery of blood is essential for severe trauma, LifeFlow could improve resuscitation and play an important role in the Golden Hour of trauma care for seriously injured children.

Pediatric Trauma Survey

In response to the summit recommendations, the Childress Institute awarded a one-year grant to Trauma and Emergency Research, Inc. (TERI) for its “Survey of Need for Virtual Trauma Network” project, which is the first step in development of a Virtual Pediatric Trauma Network.

4

iTAKL Soccer

We are funding an iTAKL pilot study to research the effects of repetitive head trauma in female soccer players, ages 13-14, over the course of a single season.

Researchers developed a custom mouthpiece that measures head impact data during athletes’ practices and games. Stay tuned for results.

Zach’s Story: ATV Injury

When Zach was 14 years old his age-appropriate ATV rolled over on him in a ditch. Zach was taken to the emergency room at their local hospital where they did a standard trauma workup including CT x-ray scans. No internal injuries were visible so they discharged Zach and told his parents to watch for any changes.

After several days Zach’s mom noticed that he had trouble eating and abdominal pain. The local hospital transferred him to a Level 1 Pediatric Trauma Center. Zach was immediately taken to the operating room to repair the abdominal damage.

Since it had been three days since his injury, he also had an infection in his stomach and part of his intestines had to be removed. His recovery involved eight follow up operations to get rid of the infection.

Pediatric trauma survivor Zach is getting back to Superman status after his ATV injury.

Even though Zach is a teenager and may not look “pediatric,” his body is still growing and changing, which required many pediatric specialists and services. Zach was able to have teachers at the hospital keep him up-to-date on his schoolwork. He had pediatric occupational and physical therapists help with his recovery, as well a child life specialist that helps teenagers. Zach is recovering well and his family is thankful for the special care he received.

iTAKL Football We continued our support of the iTAKL head impact study in

2016. The project was covered by the TODAY Show and the team published results: • • •

“Abnormalities in Diffusional Kurtosis Metrics Related to Head Impact Exposure in a Season of High School Varsity Football” was published in the Journal of Neurotrauma “Subconcussive Impacts and Imaging Findings Over a Season of Contact Sports” in the Concussion journal “Presence of Athletic Trainers in a Youth Football Organization: A Single Institution’s Experience” is in press with the Journal of Athletic Training and Sports Health Care

ATV Research

Researchers working on the ATV injury intervention project have continued their work in 2016 and published results. “AllTerrain Vehicle Injury in Children and Youth: Examining Current Knowledge and Future Needs” has been accepted for publication in The Journal of Emergency Medicine.

The study concluded a single season of high school football can produce measurable white and gray matter changes in the brain even when the player is not diagnosed with a concussion. More results are needed to determine long-term effects.

5

EDUCATION

39 countries participated including Brazil, Germany, Israel, Mexico, and Ukraine with a total audience of approx. 1,500.

Pediatric Trauma Web Symposium In September, the Institute partnered with Cincinnati Children’s Hospital to present “Pediatric Trauma: It Takes a Multi-Disciplinary Village” with program directors Drs. Richard Falcone and Todd Ponsky.

Experts from around the world discussed methods for treating and managing the pediatric trauma patient, including: • C-spine immobilization and management • Impact of trauma simulation training • Airway management • Treatment and rehabilitation of severe pediatric TBI

EMS World Scholarship

We offered a scholarship for a paramedic or EMT to receive registration and a $1,500 travel stipend at EMS World Expo 2016 held in New Orleans, LA. We chose Freya Whalen from Clever, Mo., an emergency service provider who also teaches children and parents about safety. The closest Level I Pediatric Trauma Center is four hours away, so staying current on ways to stabilize injured children is crucial to Whalen.

Pediatric Airway Course

Sports Medicine Education

Thanks to leadership from sports medicine experts Jeff Hinshaw and Dr. Chris Miles, we hosted a course to help all members of the emergency care team prepare for youth sports injuries. The course covered concussions, heat illness, spinal injury management, and how to develop an emergency action plan, as well as handson simulation of a youth sports emergency using student athletes.

Results: •

We partnered with the North Carolina Department of Health and Human Services’ Office of Emergency Medical Services to offer a free online course for all emergency medical providers on pediatric airway management. Speedway Children’s Charities in Charlotte provided partial funding for the course.

A link to the online course was distributed to all 36,000 licensed emergency professionals in NC. The topic was selected after a 2014 needs assessment survey.

According to a North Carolina Child Fatality Prevention Team report, in 2010, 68,715 of the more than 1 million emergency calls were for pediatric patients 16 year of age or younger.

6

• •

110 paramedics, EMTs, youth and high school coaches, athletic trainers, athletic directors and emergency department clinicians attended Included over 60 organizations from 10 counties in NC Funded by NC EMS for Children, the Winston-Salem Foundation and the Matthew Gfeller Foundation

Rural Pediatric Trauma Readiness Our partnership with Vidant Medical Center continued in 2016 to provide on-site pediatric trauma simulation for the top three pediatric trauma referral hospitals, including Onslow Memorial Hospital in Jacksonville, Vidant Edgecombe Hospital in Tarboro, and Nash General Hospital in Rocky Mount.

The program has become a valuable resource to the Vidant trauma system. The rural providers need education on pediatric trauma and resuscitation, and have welcomed assistance from Vidant. The fully-outfitted mobile simulation transporter should be ready for use by spring 2017.

Special thanks to the Eddie Smith Foundation for funding this program.

Joshua’s Story: Bike Helmet Safety Joshua was hit by a drunk-driver while riding his bicycle. Although armed with a properly fitted helmet, he succumbed to severe head injuries while being treated at a pediatric trauma center on May 20, 2006. His mother, Luly Beckles, turned her family’s tragedy into a passion for bike safety and injury prevention, and is now the Pediatric Injury Prevention Coordinator for Wake Forest Baptist Medical Center and Safe Kids Northwest Piedmont Coordinator.

Joshua’s family and friends gather each year for the Joshua’s Friends Foundation’s Bike Helmet Safety Event that has distributed over 2,000 properly fitted helmets to community children, as well as increased community awareness.

Safe Kids Partnership “Injury prevention happens with boots on the ground and wheels on the road,” said Luly Beckles, Safe Kids Northwest Piedmont Coordinator.

We granted funds to Safe Kids Northwest Piedmont to teach parents about car seat safety, how to install the seats properly and provide replacement seats as needed. We also helped fund the Pediatric Injury Prevention Van, which will be used to transport safety equipment like helmets and child safety seats, and provide safety tips and education to prevent pediatric injuries. Safe Kids NWP serves five counties in NC.

7

ADVOCACY Pediatric Trauma Caucus U.S. Congress Rep. Richard Hudson (R-NC) and Rep. G. K. Butterfield (D-NC) launched the bipartisan Pediatric Trauma Caucus in May 2016. Both are members of the Energy and Commerce Committee and co-chair the caucus. They hosted two Congressional Pediatric Trauma briefings, one on the pediatric trauma epidemic and another on youth sports injuries.

Richard Childress spoke at both briefings about why his family started the Childress Institute. Bob Gfeller was the moderator for both events. The briefings were an opportunity for Members of Congress and staff to learn more about the pediatric trauma epidemic and discuss next steps to support the nation’s trauma system and reduce traumatic injury in kids.

NIH

L to R: Rep. Richard Hudson, Rep. Greg Walden, Richard Childress and Bob Gfeller.

Childress and Gfeller also met one-on-one with senators and representatives to encourage support of the newly formed caucus and determine the pediatric trauma system needs in many states.

8

Gfeller attended the National Institute of Neurological Disorders and Stroke’s pediatric concussion workshop in October 2016, which brought together experts in pediatric concussion.

The goals were to identify gaps in knowledge, high priority areas of research and populations and ways to resolve these problems.

“In America” Video

The Childress Institute for Pediatric Trauma was featured on “In America” hosted by James Earl Jones on PBS affiliates throughout the U.S. The video highlighted two pediatric trauma survivors, Weezie Broughton and Meredith Cross, and their families, as well as the need for an improved system of pediatric trauma care.

Twitter @injuredkids

Facebook.com/ChildressPed

The Right Tools Video

Twitter @injuredkids

We launched “The Right Tools” video featuring Richard Childress Racing pit crew members to highlight the need to equip all emergency medical providers with the tools to save the lives of injured children. The pit crew members’ specialized, high-performance tools were replaced with basic tools, including a tire iron, jack and small gas cans, to show how important speed and the right tools are when every second counts. Watch “The Right Tools” video at youtube.com/ChildressInstitute

Facebook.com/ChildressPediatricTrauma

#OurGoldenHour YouTube.com/ChildressInstitute We raised awareness about the need for

“We’re competing where time is really important and we might lose a race or our job if it’s not done properly,” said Justin Voss, a featured pit crew member. “I can only imagine how important it is for EMS and hospitals to have the right tools because a child could lose their life.”

improved pediatric trauma care during the Golden Hour, or first 60 minutes after a serious injury. We profiled one injured child’s story each day from Nov. 5-28 and shared one story each hour on Giving Tuesday to highlight that one child dies every hour, every day from pediatric trauma.

9

EVENTS Alex’s Story Pediatric trauma survivor Alex was able to join us at the basketball tournament this year. Alex was seriously injured in a car accident when he was 7 years old. He was rushed to a nearby Level I Pediatric Trauma Center where surgeons worked tirelessly over several days to save his life. Once Alex was stabilized, it became apparent that he would be in a wheelchair and require full-time care.

Alex and Charlotte Hornet Frank Kaminsky at Dillon Brothers’ tournament.

Although his injuries were lifealtering, Alex and his mother worked with pediatric rehabilitation specialists to help Alex regain upperbody mobility and wean him off the feeding tube. Now Alex and his mom are thriving and thankful for the care they received.

Dillon Brothers Basketball Tournament 10

Sporting Clays for Kids Thanks to Rodgers Builders for presenting the 2nd Annual Sporting Clays for Kids. The 2017 event will be held on March 7-8 at the Fork Farm.

Special thanks to RCR, ECR and the Childress and Dillon family for all they do each year to support our events. Richard Childress Racing drivers and brothers Austin and Ty Dillon co-hosted the 2nd Annual 3-on-3 Celebrity Basketball Tournament presented

by The Dow Chemical Company at Wake Forest University’s Lawrence Joel Veterans Memorial (LJVM) Coliseum on Aug. 31. The 16-team, double-elimination tournament raised $100,000 to help save injured kids. Ty’s team took home the trophy. The 2017 tournament will be held on July 26.

RCR/ECR 5K

Thanks to ECR Engines, Richard Childress Racing and presenting sponsor PSI for raising over $18,000.

The 2017 run will be held on Sept. 16 at Childress Vineyards.

T. Wayne Robertson Golf Tournament

The 10th Annual T. Wayne Robertson Memorial Golf Tournament presented by SME was held on Oct. 24 and raised over $60,000 to help Save Injured Kids.

Special thanks to Silver Sponsor, the Jimmie Johnson Foundation.

Save Injured Kids Golf Classic

The 2nd Annual Save Injured Kids Golf Classic presented by Insight HP at Sapona Ridge Country Club raised over $150,000. Special thanks to our other top sponsors Ahead, Burwood Group, Grainger, VCE and Xerox for their support. Thanks to pediatric trauma survivor Grace Stokes for sharing her story. The 2017 event will be held on Sept. 19-20.

Matt Gfeller Memorial Doughnut Run Winemakers’ Dinner

Our inaugural Winemaker’s Dinner was held on May 3 at Childress Vineyards. Special thanks to pediatric trauma survivor Meredith Cross and her family for sharing their story. The 2017 dinner will be held on April 25 at Childress Vineyards.

The final Matthew Gfeller Memorial Doughnut Run was held on Nov. 12 with its biggest turn out yet: 903 runners, 100 volunteers and $73,000. Funds raised are split between the Childress Institute and the Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center at UNC-Chapel Hill. Thanks for eight great years of community support and a total $325,000 in TBI research funding to help save injured kids. We won’t let you down!

11

GRACE’S STORY: 77 DAYS IN ICU Trauma Center. After many tests, they realized I had mucormycosis, a rare, deadly infection with only 50 percent survival rate. It’s fungal not bacterial, which explained why the antibiotics never worked. They said if they didn’t get the infection stopped and it got in my femur, they’d have to amputate my leg at my hip, and if it went through my femur and into my pelvis I’d die.

Dr. Carter’s team used every tactic possible to keep the infection at bay, including daily surgeries, hoping an extremely high dose of a special medication would start to reverse the infection’s progress without causing my body additional damage. After several weeks and many surgeries they determined the infection was gone and started to reconstruct my leg.

I was moved into the burn ICU and kept in isolation to prevent further infection.

Pediatric trauma survivor Grace Stokes shares her story at our golf tournament dinner with the help of her champion, Dr. Jeff Carter.

On June 28 I was on my way to the beach when a large SUV ran a stop sign and hit my side of the car. The impact was so intense it ripped my door off and crushed the right side of my body. I was airlifted to a nearby hospital with a double compound fracture of my tibia and fibula, pelvis broken in four places, pubic bone broken in two places, a broken rib and I was hemorrhaging.

I was in surgery for five hours and it was not certain if they could save my lower leg. Fortunately, they did and after three more surgeries and about two weeks in the hospital, I was about to go home with a titanium rod from knee to ankle and multiple pins and screws. Then my thigh started to really hurt and I got sick. The doctors tried to operate and take tissue samples to see what kind of infection I had but lab results were inconclusive. They administered several antibiotics but nothing worked and it was getting worse.

They realized I had a necrotizing fasciitis that was destroying my soft tissue, but they couldn’t get the infection stopped so I was moved to a Level I Pediatric

12

Because the infection had taken all the skin, tissue, fascia, and even some muscle, they had to create a new tissue surface for me. The doctors used an experimental tissue and surgically implanted it all over my leg. Luckily my leg accepted the tissue and after several weeks of growth, I had a special skin graft surgery to cover my wound.

During all this I had 30 blood transfusions, multiple radiology procedures, collapsed veins, stomach complications, and feeding tubes.

Every day was a different challenge, but there were more victories than defeats.

After 21 surgeries and 77 days in intensive care, my leg was repaired and then my real work started. I had to learn to walk again.

Because of the damage to my muscles they weren’t sure how much I’d be able to move. The projection was that I might be able to walk with the aid of a walker

by Christmas. I started walking a little by the time I finally left the hospital on September 11 and worked each day with my wonderful physical therapist at my house. I stopped using a wheelchair or walker by October and stopped using a cane by Halloween.

I’m now in college studying to get my nursing degree and majoring in Exercise Science Physiology with a 4.0 GPA. Thanks to the relentless efforts and innovative medical brilliance of my surgeons and health care providers, I am fulfilling my dream to become a nurse and help others like me.

We are fortunate to have partners that fund our mission through grants and sponsorships throughout the year. Special thanks to those that supported us at $5,000 and above:

Grace Stokes at age 17 before her injury

“LIFE IS SHORT. IT CAN CHANGE IN AN INSTANT. NEVER GIVE UP.” – Grace Stokes, pediatric trauma survivor

2017 Funding priorities: Education Pediatric Trauma Society Partnership Childress Scholar EMS Education Sports Medicine Education Course Heads Up Clinics Community Safety Program Athletic Trainer Education

Research $25,000 $25,000 $20,000 $20,000 $20,000 $10,000 $5,000

National Research Grant Pediatric Medical Device Grant iTAKL Research CSII Education Initiative CSII Rural Needs Assessment CSII Dashboard Project

$100,000 $50,000 $50,000 $50,000 $40,000 $40,000

This Childress Institute for Pediatric Trauma is a registered 501c3 charitable organization.

Our financial information and Form 990 can be found at

13

Childress Institute for Pediatric Trauma Wake Forest Biotech Place 575 N. Patterson Ave., Suite 148, Winston-Salem, NC 27101 CIPT@wakehealth.edu \ 866-635-8190

Fac

Twitter @injuredkids

Facebo

Twitter @injuredkids Twitter @injuredkids

Facebook.c

Twitter @injuredkids

Twitter @injuredkids Facebook.com/ChildressPedia

Facebook.com/ChildressPediatricT YouTube.com/ChildressInstitut Twitter @injuredkids

YouTube.com/ChildressInstitute Facebook.com/ChildressPediatricTraum YouTube.com/ChildressInstitute

An electronic version of this report can be found at SaveInjuredKids.org

The Childress Institute for Pediatric Trauma was founded at and receives considerable support from Wake Forest Baptist Medical Center. The Institute was established through the generosity of Richard and Judy Childress.