By Blake Alsup
Northeast Mississippi Daily Journal
TUPELO, Miss. — As a Level II Trauma Center, North Mississippi Medical Center-Tupelo is equipped to handle complex trauma cases and emergency surgeries around the clock, with a guaranteed 15-minute response time for trauma patients.
However, the response time is typically far faster than that with EMTs, paramedics and flight crews notifying trauma surgeons of incoming patients as they’re transported so that a surgeon can be there the moment the patient arrives.
“Our average response time is like one minute because of that,” said Dr. Kirk Caddell, a trauma and acute care surgeon at NMMC-Tupelo. Caddell provides emergency general surgery and trauma services to acutely injured and ill patients.
Caddell, 51, completed medical school at Oregon Health & Science University in Portland, Oregon, and a general surgery residency at the University of North Carolina at Chapel Hill.
He began working at the North Mississippi Medical Center Gilmore-Amory in 2016 as a general surgeon. In 2018 and 2019, he deployed with his Army Reserve unit, which is a Forward Surgical Team, on tours in Afghanistan.
After that, he got involved with a company called Vigilint, working on a five-person mobile surgical/resuscitative team in Africa. After more than a dozen rotations with the team and six months out of the year overseas, Caddell decided to look for a job locally in the Northeast Mississippi area.
He’s worked in Tupelo for two years now, and though his schedule varies, Caddell typically works 10 24-hour shifts each month at the hospital. During a shift, Caddell is on-call and available to respond to any trauma patient who comes to the hospital.
Typically, the patients Caddell sees are victims of motor vehicle or all-terrain vehicle accidents, gunshots, stabbings or emergency general surgery patients with urgent/emergent problems like perforated or obstructed colons, along with infections causing sepsis. He also commonly sees people with acute gallbladder and appendix issues.
Within a triangle stretching from Jackson, Mississippi, to Memphis, Tennessee, to Birmingham, Alabama, NMMC-Tupelo is the sole trauma center between them.
When a trauma patient arrives, surgeons follow a protocol developed by the American College of Surgeons to evaluate them.
“That happens in a very formulaic way, addressing life-threatening injuries first,” Caddell said. “We talk about ABCs — airway, breathing and circulation — so we start that way every single time, and we run through that evaluation of the patient the same way. That helps prevent misses on injuries and also helps expedite getting folks to an intervention if they’re in need of one.”
Medical professionals have learned from decades of treating patients that a delay in care of just a single minute has a measurable impact on mortality. Mortality rates are lower in areas where high-level trauma services and acute care surgery services are available, Caddell said. That benefit and responsibility to the community is something he takes seriously.
“The more efficient that we are in delivering those first 10 to 15 minutes of care — including pre-hospital care and the way that’s delivered — that matters to patients,” Caddell said.
The first objective when a patient arrives is to stabilize their condition. This looks different with each patient. Stabilizing the patient could mean resuscitation, clearing their airway, or other interventional measures. Surgeons address the most serious issue, and then move on to the next most serious.
“There’s a concept called damage control surgery,” Caddell said. “For example, if you had somebody with an intra-abdominal bleed and they had a bowel injury combined, the goal is to stop the bleeding, stop the contamination. And then, if you need to, sometimes we’ll temporarily close the abdomen, take them to the ICU to continue resuscitation, and then when they’re stable, we’ll come back and complete things.”
Though the work of trauma surgeons like Caddell is essential, he stressed they are part of a comprehensive system of health care professionals working not just to keep the trauma patient alive, but to get them back into the community.
It begins with prehospital care from highly trained emergency medical services (EMS) teams, paramedics and flight paramedics and nurses, he said.
Upon arrival at NMMC-Tupelo, a patient is assessed and treated by physicians and nurses in the emergency department, as well as trauma and general surgeons who are ready to perform emergency surgeries ranging from internal bleeding to head trauma and complex fractures.
Besides general surgery, the hospital offers a variety of sub-specialty surgical services like orthopedic trauma, neurosurgery, interventional radiology and vascular and cardiothoracic surgery, Caddell said. This ensures patients receive thorough care for complex injuries.
The nursing staff is another vital part of the trauma care provided at NMMC-Tupelo, he said, and while recovering from a traumatic injury, the rehabilitation services offered by the hospital — including physical therapy, occupational therapy and speech therapy — help patients regain their strength and independence.
“There’s a lot of ways you can ‘save someone’s life’ but not get them back to functional if you don’t have all of those pieces lined up and people coordinating and working together,” Caddell said.
The goal is to get the patient back to the living the life they had previously despite a traumatic injury or acute illness.
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