Advanced Care for Critical Injuries

Scripps is one of the leading providers of trauma care in San Diego County. Scripps physicians Brent Eastman, MD, and Richard Virgilio, MD, were instrumental in establishing San Diego’s regional trauma system and creating a model for trauma systems across the nation. Dr. Virgilio was initially hired at Scripps Mercy Hospital as a vascular surgeon, but in 1984, he helped open the Level 1 Trauma Center at Scripps Mercy and became its first leader. 

“I wanted to create an environment countywide where people who were severely injured — from a gunshot wound, from an automobile accident, from a fall — that you could get optimal care in the shortest period of time,” he says. 

Dr. Eastman took the helm of the trauma center at Scripps Memorial Hospital La Jolla and later became Scripps Health’s chief medical officer. 

“When I arrived in San Diego in 1972, I became aware of the fragmentation of trauma care in our county. Injured patients were taken to the nearest hospital, regardless of the nature of the calamity or the resources available to treat them,” he says. “I was one of a handful of young surgeons fresh from training where things were done differently, and we slowly found one another and began plotting to build a new system.” 

The San Diego County Trauma System linked all local trauma centers to better provide emergency care for severely injured patients and served as a model for other municipalities across the country. In the year that followed, the preventable death rate dropped from 21% to 1%, where it has remained ever since. 

Scripps continued to expand its services and excel in emergency medicine. In 2003, Scripps Mercy Hospital was designated as a Level 1 Trauma Center. Conrad Prebys Emergency and Trauma Center was dedicated in 2012 and Barbey Family Emergency and Trauma Center followed four years later. In 2022, Scripps Memorial Hospital La Jolla was also designated as a Level 1 trauma center, making it the second within the Scripps system and the third in San Diego County. 

Scripps provides immediate, highly specialized care to more than 3,500 critically injured patients every year, many of whom arrive by ambulance or helicopter. Scripps has been making the journey to the hospital faster and safer for patients since it received its first ambulance in 1967 and empowered medical professionals to provide care en route to the hospital. This commitment to care took to the sky in the early 1980s when Life Flight helicopters began bringing patients to Scripps Memorial Hospital La Jolla. They began serving all Scripps hospitals in 1983. 

In 2017, Scripps reaffirmed its commitment to using the most advanced and effective treatments when it became the first in California to begin whole blood transfusion for hospital trauma patients. 

Though common in the first half of the 20th century, whole blood transfusions were largely phased out in favor of component blood that was broken down into blood cells, platelets and plasma. Whole blood transfusions reemerged during the conflicts in Iraq and Afghanistan when component blood was not always readily available to military doctors. Civilian doctors then adopted the practice and studies have shown that it leads to better patient outcomes. 

“We learned a lot in the wars in Iraq and Afghanistan, and brought lessons from the front lines to the homefront, and that completely changed the way we took care of patients who were critically injured with hemorrhagic shock blood loss,” says Michael Sise, MD, former trauma medical director at Scripps Mercy Hospital, who previously served in the U.S. Navy. 

Patients who received whole blood transfusions were surviving at a significantly higher rate and had fewer complications after resuscitation. “It transformed the survival rate in these patients,” says Dr. Sise.