On a balmy afternoon nearing the end of the school day, April 26, 2022, a gunman, perched on the balcony of a nearby apartment building and armed with a rifle with hundreds of rounds of ammunition, rained down more than 200 bullets on a neighboring school in Washington, D.C. The gunfire shattered glass and sent students, faculty, and staff scrambling for cover. When the shooting stopped, four people lay seriously wounded, including Officer Antonio Harris, a retired D.C. police officer and the school security officer, who was among the most critically injured.
Seven months later, Harris stood with three other survivors of life-threatening trauma to honor the commitment of the doctors, nurses, physician assistants, paramedics, and all who were on their care teams who saved their lives during 11th annual George Washington University Hospital (GW Hospital) Trauma Survivor’s Day, Nov. 10.
“The purpose of today is to reconnect with some of our patients who sustained exceptionally severe injuries, and who touched our lives, and to acknowledge the members of the trauma team who work night and day to put this together,” said Babak Sarani, MD ’97, RESD ’04, director of trauma and acute care surgery at the GW Medical Faculty Associates, who leads GW Hospital’s Level I Trauma Center. “Saving the lives of a fellow human beings, requires the combined strength and perseverance, first and foremost, of the patients, their family, their social support, and the entire spectrum of the health care sector. There is no department in [GW Hospital] that is not involved in the care of these types of patients.”
Now in the Trauma Center’s 11th year, Sarani outlined several of the key advances that have helped GW expand access to lifesaving critical care for the D.C. region. In 2014, as the opioid crisis took root across United States, the Trauma Center worked closely with the Department of Anesthesiology to address the routine use of narcotics and opioids. They followed that by launching a critical care ambulance program to help shave time getting patients from outside hospitals to GW. Three years ago, GW Hospital opened the helipad enabling critically ill patients to be airlifted.
“Last year,” Sarani told the audience, “we became the first trauma center in Washington, D.C., to use whole blood as a means to resuscitate our trauma patients.” This year, he added, GW Hospital became the only facility in the region to receive centers of excellence designations from medical device company, Prytime Medical, and the Chest Wall Injury Society in recognition of the Trauma Center’s record of successful outcomes.
“It’s a great honor to be here in front of this group and to recognize the remarkable teamwork it takes to take care of the most critically ill,” said Barbara L. Bass, MD, RESD ’86, professor of surgery, Bloedorn Professor of Administrative Medicine, vice president for health affairs, dean of GW SMHS and CEO of The GW Medical Faculty Associates (GW MFA). “Our Level I Trauma Center designation is a marker of what our team is about. It starts, long before injured patients get to our door, with rigorous attention to the accreditation standards.”
“A recurring theme you’re going to hear today is the incredible work offered by our neurosurgeons and our orthopedic surgeons, as well as the intensive care staff, nurses, therapists, and orthopedic surgeons among others,” Sarani said as he introduced the day’s survivors.
Among the four patients on hand for the event, two came to GW’s Trauma Center after being hit by cars. Samuel Kurtz was struck while crossing Connecticut Avenue on Jan. 4, and sustained severe traumatic brain injury and a broken hip. Charles Mason Bussmann, was found lying in the street suffering from a severe skull fracture, multiple broken bones in the face, a broken back, and a broken arm.
“I’m grateful for this meeting, especially the George Washington University Hospital,” Bussmann said. “The time these doctors and nurses took working on my life-or-death trauma was so important and is very appreciated. My current mental health disability program and the program for my traumatic brain injury is helping me be successful and reach my future accomplishments. Thank you for this opportunity.”
The day’s third survivor, Charles Wapner, was the victim of a violent assault. When he originally arrived at GW Hospital his condition was “pretty stable,” Sarani said, but things changed quickly.
Wapner’s blood pressure spiked, raising alarm bells among the trauma staff. He was quickly intubated and rushed to the operating room where neurosurgeons worked to relieve the pressure on his rapidly swelling brain.
“After many weeks in the ICU,” added Sarani, “with unwavering care from our therapists, our nursing staff, our intensive trauma team, the neurosurgery team, he was able to be discharged to Pennsylvania [to be close to his family] where he continued weeks of intensive rehabilitation therapy.”
The last survivor to be introduced was Harris, but not without good reason.
“Officer Harris sustained probably the worst injury I have seen thus far in my career,” recalled Sarani. “He was bleeding from his liver, kidney, and intestines because the bullet had penetrated his abdomen through the back.”
The injuries were so severe, the trauma team had to pull out all the stops to save his life, from dozens of units of whole blood to help revive him, to a cocktail of drugs in an effort to control his bleeding. However, it was the REBOA catheter, or Resuscitative Endovascular Balloon Occlusion of the Aorta, that enabled the team to regain control of the bleeding and buy the time necessary to repair the damage.
Physicians threaded the catheter, a narrow tube with a balloon at the end of it, through the body and into the aorta, by way of the femoral artery. Once there, physicians inflated the balloon halting blood flow, but also stopping the bleeding. By the time he was stable, Harris would need 85 units of blood, while also becoming the longest successful use of the REBOA catheter. Sarani and his team kept the catheter partially inflated to control the blood flow for more than 20 hours.
“With that, we were able to control how much was bleeding, how much was not bleeding,” said Sarani. Meanwhile the trauma team continued to transfuse Harris and give his body a chance to recover. “I am convinced, beyond a shadow of a doubt, that without a REBOA catheter, Officer Harris would have died that night.”