Veteran Va. Trauma Surgeon Hangs up Stethoscope
Dec. 31--Over a 30-plus-year career in medicine, trauma surgeon Rao Ivatury has helped save many hanging on to life by a thread.
They include the man who was shot by the D.C.-area sniper in Ashland in 2002 and brought to VCU Medical Center.
Another patient is one Ivatury, who retires today, remembered from his days at a New York City hospital. The man had been stabbed in the chest at Yankee Stadium and brought to the hospital by his friends in a cab.
"He was practically dead. He was not breathing much," Ivatury said, recalling the incident that happened around 1989 or 1990.
The man walked out of the hospital three to four days later, said Ivatury, who since 1998 has served as chairman of trauma, critical care and emergency general surgery in the Department of Surgery at VCU Medical Center.
Ivatury, who has written extensively on resuscitation, shock and abdominal injury and more commonplace topics such as red light cameras as crash deterrents, said he plans to stay involved in trauma medicine through his work with the Panamerican Trauma Society, his academic and research writings, and by "giving back to the community."
Trauma care, he said, has become more organized and evidence-based.
VCU Medical Center has been recognized as a Level 1 trauma center since 1981 when the state started such verifications. The medical center also has national certification as a Level 1 trauma center from the American College of Surgeons.
"We've also improved our understanding of how injured patients die," Ivatury said. "We began to understand the physiology and all the things we need to do urgently to maintain that life. So a lot of what we have done recently, in the last decade, is focused on trying to stabilize the patient, normalize everything in his body and then going back and repairing the organs."
"Damage control," is how Ivatury describes that concept of doing what's needed to keep the patient alive until the body can take more invasive procedures.
Improving trauma care also has focused on pre-hospital care, said Chip Decker, chief executive officer of the Richmond Ambulance Authority. Decker has served with Ivatury on a state Emergency Medical Services Advisory Board. It's been drilled into people's heads to call 911, for instance, instead of trying to drive a critically injured person to a hospital.
"If the patient expires in the field, then that's the end of the story," Decker said.
"You have to have a viable patient, and you have to have good pre-hospital care to get them to the trauma center in a condition that they can work their magic once they get there."
Ivatury, he said, was one of the thought leaders on the topic, often providing feedback to EMS crews who generally lose contact with patients once they drop them off at the hospital.
"There was a lot of information going back and forth about how our patients were doing, patient outcomes, and things that we could do better so we could deliver a patient in improved condition or at least stabilize better in the field," Decker said.
"(Ivatury) has always been an advocate for EMS education," he said. "Maybe I can draft him into teaching."
At VCU, students have recognized Ivatury as an outstanding educator. Ivatury also co-edited "The Textbook of Penetrating Trauma" (1996), about which one reviewer said, "The broad range of topics covered makes the book a more useful reference than its title would suggest."
Trauma, Ivatury noted, is not just shootings and stabbings but includes falls, domestic violence assaults, burns and even insect bites, among other conditions.
Trauma surgeons internally debate such issues as how much blood or clotting factors to give a critically injured patient, but they also weigh in on broader societal issues.
"Gun violence is something we have to do something about, especially when you are talking about mass shootings, school shootings," Ivatury said. "School security is not the answer."
"No developed country has this problem as we have. ... All potential answers must be pursued."
Ivatury, 65, is married to Dr. Leela Kriplani, a retired anesthesiologist.
Copyright 2012 - Richmond Times-Dispatch, Va.