childress institute for pediatric trauma - annual report 2014

2014 STATE OF THE INSTITUTE REPORT

MISSIONWe discover and share the best ways to prevent and treat severe injuries in children.

VALUESCOLLABORATE: Collaborate always to create the win for all parties.

MEASURE: Plan and do what can be measured. Outcomes matter.

LEAD: Be proactive, a fast follower is still a follower.

CARE: Value and nurture every relationship.

THINK BIG: Adopt an explorer mindset – bold, uncharted, creative.

ACCENTUATE THE POSITIVE: Our work is a journey with daily progress.

GOAL #1 IMPROVE CARE: Raise the quality of care for severely injured kids. We can be the catalyst for positive change.

GOAL #2REDUCE INJURY: Fund initiatives to prevent and treat injuries in youth recreation and sports.

STATE OF THE INSTITUTE REPORT 2014 1

From the Executive DirectorI joined Michelle, Sara and Kara at the Institute as executive director in April 2014. We spent the next eight months determining how we can reach new goals. We revised our mission and narrowed our focus to 1) improve pediatric trauma care and 2) reduce injuries in youth recreation and sports. We will achieve these goals by funding research, providing education and leveraging advocacy opportunities.

We are all thankful for the unparalleled leadership of Dr. J. Wayne Meredith, who led the Institute for six years through its creation, infancy and formative “toddler” years, all while maintaining his full time roles at Wake Forest Baptist Health. His internationally-renowned reputation in the trauma world helped the Institute gain recognition with leaders in the pediatric trauma field. We are thrilled Dr. Meredith will continue as our mentor and medical advisor.

We are starting to see results from the research Dr. Meredith initiated. The studies we helped fund are getting their results published and garnering national attention. In keeping with our new goals, we funded a national research grant in 2014 to encourage others interested in improving pediatric trauma care, and continued with a second grant application that was awarded on January 1, 2015. The ATV and youth sports studies we helped fund will make recreation and sports safer for kids.

We launched a donor-funded program at Vidant Medical Center in Greenville, N.C., that has the potential to be replicated in other rural communities. Another donor-funded program made it possible to have a certified athletic trainer at all practices and games for the South Fork Panthers youth football team. Our education initiatives provided medical knowledge for clinicians and a greater awareness about pediatric trauma among the general public.

We expanded our reach nationally by joining other voices that support pediatric trauma research and awareness. President Obama hosted the Healthy Kids and Safe Sports Concussion Summit at the White House in May, and my wife, Lisa, and I attended. Dr. Valerie Maholmes is leading the National Institutes of Health’s Pediatric Trauma and Critical Illness Branch, and we look forward to partnering with her group as they determine how the branch will improve pediatric trauma care.

We are continuously working to expand our reach through events, traditional media, social media and strategic partnerships. We launched our new website and blog to discuss pediatric trauma topics – visit SaveInjuredKids.org to learn more. Please visit our new site, find us on social media and tell your friends! We need your help to achieve our mission.

Thanks for your continued support! Stay inspired!

Bob Gfeller

Bob Gfeller, Executive Director

2 STATE OF THE INSTITUTE REPORT 2014

Distinguished Service AwardDr. Meredith received the 2014 American College of Surgeons (ACS) Distinguished Service Award in appreciation of “his continuous and devoted service as a Fellow of the American College of Surgeons” and “in recognition of his distinctive scientific contributions in cardiovascular physiology during resuscitation, trauma registries, and trauma systems.”

The ACS is a scientific and educational association of surgeons that was founded in 1913 to improve the quality of care for the surgical patient by setting high standards for surgical education and practice. The College currently has more than 80,000 members and Dr. Meredith has been a Fellow of the ACS since 1990. The award is the highest honor bestowed by the ACS.

The Childress Institute greatly appreciates all of the hard work Dr. J. Wayne Meredith has contributed during his six years as our executive director. Major accomplishments on our behalf:

• Shared his passion about pediatric trauma with Richard and Judy Childress, which lead to our initial funding and launch in July 2008

• Provided pilot funding of the head impacts in youth football study in 2012 which lead to a $3.8 million grant from the NIH and ongoing research

• Created the CIPT Scholar program to encourage and allow young medical professionals to further their study of pediatric trauma

• Helped Wake Forest Baptist Medical Center’s Brenner Children’s Hospital attain its designation as a Level I Pediatric Trauma Center, one of only 14 in the U.S. at the time (2011)

• Led the formation of the 2013 Childress Summit of the Pediatric Trauma Society, a unique convergence of experts to create a 10-year plan to address pediatric trauma issues

• Co-hosted three pediatric trauma web symposiums to share cutting-edge techniques with surgeons and medical professionals around the world

• Gave countless heartfelt speeches, blogs and pep talks inspiring others to help save injured kids

Dr. Meredith receives ACS award from Dr. Carlos A. Pellegrini, 2014 ACS President


J. Wayne Meredith Fund

In honor of Dr. Meredith’s passion for pediatric trauma, his colleagues have donated over $60,000 to start the J. Wayne Meredith Fund. Program details will be announced in 2015.

Childress Summit 2015The next Childress Summit is planned for May 2015 and attendees will work on an action plan for several projects, taking the 2013 summit’s recommendations from concept to practical application.

The Childress Institute for Pediatric Trauma co-hosted a national pediatric trauma conference in 2013 to assess the state of pediatric trauma care in the U.S. and create a plan for best practices in research, treatment and education. Attendees included 56 representatives from 18 states representing children’s hospitals, trauma centers, research facilities and government agencies across the U.S.

White papers generated after the summit form the basis of a combined report published in the September 2014 issue of the Journal of Trauma and Acute Care Surgery.

Report recommendations:

• Create a comprehensive set of pediatric-specific outcome measures, including TBI

• A national ‘‘needs assessment’’ should be completed to evaluate geographic distribution of children, frequency and types of pediatric injuries in individual communities, and availability and access to pediatric care resources

• Create a Virtual Pediatric Trauma Center, to help practitioners care for injured children in locations remote from tertiary care

• Create a Pediatric Trauma Toolkit, a ready resource to develop and distribute educational tools and clinical practice guidelines for better management of pediatric trauma patients

• Create a Pediatric TBI Consortium and a national TBI research database

• Educate stakeholders about how guidelines can improve processes and outcomes

Attendees at the Childress Summit of the PTS, April 2013


Goal #1 Improve Care Goal #2 Reduce Injuries

The Golden Hour

The time following a traumatic injury when prompt medical treatment has the highest likelihood to prevent death 30% of kids in the U.S.

cannot reach a trauma center within the golden hour

90%of injured kids do not receive care at a pediatric trauma hospital. More kids die when they are treated in rural areas without access to trauma

Treatment at a trauma center improves chance of survival by 25 percent

1hour

25%

Sources and statistics used throughout report courtesy of:

Raise the quality of care for severely injured kids.


Goal #2 Reduce Injuries

in emergency room visits forsports-related TBIs in the last 10 years

13Average age from

an ATV injuryamong kids 12

Between 1996 and 2000, more than one-third of inpatient ATV-related hospital admissions were children under 12

Average age of child passengers injured in an ATV accident

925%

100,000More than

100,000 ATV injuries in 2012,

25 percent were kids under 16

Fund initiatives to prevent and treat injuries in youth recreation and sports.


ResearchATVsDr. Laura Veach, Dr. Thomas Pranikoff and their team have reviewed and analyzed all-terrain vehicle (ATV) statistics and literature to access risk factors contributing to ATV injuries in children and ado-lescents. Based on this review, new approaches for intervention models can be developed that are more informative and effective at preventing and decreasing injuries, as well as high risk behavior, while operating ATVs.

Three risk factors contributed to an increase in death and injury for young ATV riders:

• Driving machines that are too powerful

• Kids are riding adult ATVs

• Dangerous riding behaviors – Kids are not wearing helmets, and many are driving on paved roads which increases rollovers

Researchers are preparing a manuscript that includes a literature review, supportive data from BrennerChildren’s hospital Level I trauma center and suggested strategies for risk behaviorintervention.

Next step:

• We are funding an intervention education pro-gram, modeled after the suc-cessful Violence Intervention Screening and Initial Treatment (VISIT) program, previously funded by the Institute

iTAKLSince 2012, the Institute has provided $350,000 to the Center for Injury Biomechanics at Wake Forest University to support the iTAKL study, a medical image data collection of head impact, neurocognitive, and imaging data from 147 youth and high school athletes.

Initial results proved promising enough for the National Institutes of Health (NIH) to grant $3.8 million to continue this study in youth players for the next five years.

Preliminary results:

• Greater percentage of head impact exposure during practices compared to games

• Increasing number and severity of impacts with increasing age

• Cumulative effect of head impacts over a season could produce measureable changes in brain images of high school players similar to brain changes associated with mTBI

Next steps:

• Preparing manuscript to underline impact of having a full time athletic trainer at all practices and games; target to publish in athletic training journals

• Football study will continue at least through 2019

• Study head injuries in other sports, helmeted and non-helmeted, as well as in boys and girls of sports-related injuries

occur during practicerather than in games

62%90%

of kids injured or killed riding an ATV are on a vehicle exceeding manufacturer recommendations for their age


Crash Notification CIPT Scholar Dr. Andrea Doud’s research is focused on creating an Advanced Automotive Crash Notification (AACN) system that will help Emergency Medical Technicians (EMTs) decide if children need treatment at a trauma center after a motor vehicle crash. While AACN systems have been developed for adults, no such systems have been developed specifically for children.

By the time the EMT team arrives on the scene, determines helicopter transport is necessary and sends for such transport, critical time is wasted that is best spent treating injuries.

AACN systems use information recorded in a vehicle at the time of the crash, such as speed and direction of impact, which can help predict the severity of the injuries occupants in the vehicle are likely to have sustained. This information can be transported from the vehicle’s black box to EMTs so that the appropriate resources can be immediately utilized. AACN will not replace the ability of EMTs to assess and treat children but will improve the ability with which they can do so quickly and correctly.

Does the addition of AACN helpafter a Crash?

Dr. Lawrence J. “Larry” Cook at the University of Utah School of Medicine received the Institute’s second national research grant of $75,000. His project will create a database with information on pre-hospital and in hospital care of injured children to understand how care by pre-hospital providers (EMS) affect outcomes of children with TBI. Dr. Cook specializes in Pediatric Critical Care and Public Health. He was selected in fall 2014 and funding began on January 1, 2015.

Expected results:

• Data analysis will inform EMS transport decisions for children with moderate to severe TBI

• Results may support a future effort to create a comprehensive national pediatric TBI database

National Research GrantsDr. Frederick Rivara, a professor of pediatrics at the University of Washington in Seattle, received a $75,000 grant for his research project titled “Development of the Pediatric Trauma Assessment and Management Database.”

The goal of his research is to help reduce pediatric trauma deaths by developing a unique database created by the linking of two different sets of data on pediatric trauma patients. His group has been testing the usefulness of the database by examining the care of critically injured children. Dr. Rivara believes this will lead to the development of appropriate quality of care indicators to assist those treating pediatric trauma patients. Initial results are expected by June 2015.

Does an AACN help after a crash?


EducationBike Safety Events

We teamed up with Richard Childress Racing, the Joshua’s Friends Foundation, local police departments’ bike patrol, and the Safe Kids organization to promote helmet safety in May with two events at local elementary schools in the North Carolina. The police and RCR pit crew members spoke about how important wearing a helmet is in their job. The students were all properly fitted for and received a free bike helmet.

Budds Fund Athletic TrainerRichard Budd and his son Joe Budd created a $100,000 endowed fund at the Institute in memory of Christopher Budd, Richard’s grandson and Joe’s nephew, who died from a traumatic injury. This year funds from the endowment provided a certified athletic trainer for the 2014 South Fork Panther football season.

There are approximately 150 South Fork Panther athletes. It is estimated that each athlete will participate in approximately 200 hours of football practices and games. The Budds’ support makes it possible to have a certified athletic trainer at all practices, scrimmages, and games to help treat minor injuries and identify concussions for all South Fork Panther athletes.

Athletic trainers play a vital role on the field to identify and treat athletic injuries. Athletic trainers are most commonly present at the high school, collegiate, and professional levels, despite the large numbers of children participating in youth sports and the unknown rates of concussion for this population. Youth league football greatly benefits from having a certified athletic trainer, especially to aid in identification and treatment of concussion.

Pediatric Trauma ConferenceThe 5th Annual Wake Forest Baptist Health Brenner Children’s Hospital Pediatric Trauma Conference was held in October. We funded a complimentary Pediatric International Trauma Life Support (PITLS) training course and special guest speaker Dr. Jonathan Groner, trauma medical director of Nationwide Children’s Hospital in Columbus, Ohio. The conference presents health care professionals with knowledge about pediatric trauma care from the pre-hospital phase through discharge.

Pediatric Web SymposiumIn February, the Institute presented “Pediatric Trauma III - New Paradigm of Care” co-hosted by Dr. Wayne Meredith, medical advisor of the Institute.

Results:

• 26 countries participated, including Brazil, Egypt, France, Greece, Korea, and Serbia

• 368 unique registration centers

• Total audience 1,400

• Participants received Continuing Medical Education (CME) credit

• Shared key lessons at #PedsTrauma2014 on

• View the presentations on

Website & BlogThe Institute launched a new website in late November to create our unique brand, highlight our work and raise awareness about pediatric trauma. Help us and share our message by visiting SaveInjuredKids.org.

We also started a blog to bring fresh perspectives from nurses, doctors, emergency medical professionals, patients and their families. Our goal is to give a voice to pediatric trauma. Visit our site to read more.

Twitter @injuredkids Facebook.com/ChildressPediatricTrauma YouTube.com/ChildressInstitute

Twitter @injuredkids

Facebook.com/ChildressPediatricTrauma

YouTube.com/ChildressInstitute





Common signs of concussion:

?? ?

Dizziness Nausea LightSensitivity

Headaches Confusion


RCR PartnersIn September, RCR Sprint Cup driver Austin Dillon teamed up with Cheerios to visit the Children’s Hospital of Richmond at VCU (CHoR) to bring some cheer to the kids. For more details, read Austin’s blog about his visit with the kids, or view the video and photos on our Facebook page.

Quicken Loans featured the Institute as one of three charities in its “Paint Your Way to Dover” online sweepstakes. We received $2,500 and were able to share our mission to save the lives of injured children.

PartnersWe are fortunate to have partners that help fund our mission, including:

Helmet Selfie Chat The Childress Institute for Pediatric Trauma hosted a Twitter chat at #HelmetSelfie to discuss prevention and treatment options for reducing head injuries in kids on December 2 in honor of “Giving Tuesday.” Richard Childress Racing drivers and other sports figures supported the campaign by posting photos of themselves and family members wearing helmets to encourage helmet use.

Industry experts discussed:

• Latest research about children’s head injuries

• Education about how to protect kids from head injuries during recreation and sports

• Advocacy suggestions for parents/families, athletes, trainers, physicians and coaches

• Signs and symptoms of a possible concussion

• Treatment options

Learn More

MediaThe Institute had two major newsworthy topics in 2014 with the addition of Bob Gfeller as our executive director and the publishing of the “Abnormal White Matter Integrity Related to Head Impact Exposure in a Season of High School Varsity Football” paper in the Journal of Neurotrauma.

Each year, U.S. emergency departments treat an estimated 173,285 sports- and recreation-related traumatic brain injuries, including concussions, among children and adolescents from birth to 19 years old, which equals almost 20 injured children every hour.* A concussion is a brain injury and all are serious, with most concussions occurring without loss of consciousness. Proper use of helmets and recognition of head injuries can prevent injury or even death.














AdvocacyThe Gift of Childhood

Nothing compares to saving the life of a child. There’s no greater return on investment we can make as a society. When you save a child, you save a childhood, a family, a future. We should be ready and able to save a child when injury threatens their life, no matter where we live.

Your support helps fulfill our national mission.

2015 Priorities

Research

Girls’ Soccer Concussion Study $25,000

ATV Safety Counseling Study for Behavioral Change $20,000

Athletic Trainer Staffed for Youth Football Concussion Study $15,000

Education

Local Area NFL Heads-up Youth Football Training Clinic $15,000

EMS Regional Speaker Series $10,000

Childhood Burn Care Continuing Medical Education $20,000

Elementary School Bicycle Safety Events $5,000

White House Concussion Summit

Bob Gfeller and his wife Lisa were invited to attend President Obama’s Healthy Kids & Safe Sports Concussion Summit at the White House in May. They were invited because of their passion, advocacy and commitment to making sports safer for all children. The Gfellers lost their younger son, Matthew, after he sustained a traumatic brain injury during a high school football game in 2008.

The power of the Presidential position brought a large team of people to the White House that are interested in positively impacting this invisible threat to our kids – medical professionals, sports advocates/players (football, soccer, hockey, etc.), parents and other family members, corporate supporters, the military, media and others. Many people are talking about the NFL, but kids make up

the majority of players and they are vastly under studied. It’s vital that we research ways to improve outcomes. Until then, “when in doubt, sit it out,” and keep yourself informed.

Governance Board

Richard Childress Terry Hales Dr. John McConnell Dr. J. Wayne Meredith

Growth Advisory Board

Betsy Annese Tina Dillon Myles Gillespie Charles F. GfellerDr. Lisa HembyPeter Schaffer Mike SheinMichael Taylor

National ResponsibilityThe National Institutes of Health (NIH) formed the Pediatric Trauma and Critical Illness Branch (PTCIB) in 2012 under the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), the institute focused on children’s health issues. It demonstrates a recognition that, in our nation, one of the most serious public health problems for children is injury, and that injury in children requires and merits some focus by our nation’s most important federally-funded research support structure.

I’m very gratified to see that Valerie Maholmes, Ph.D. has been appointed as the chief of this division. She has a lifetime of commitment to children, to children’s health issues, children’s

injury issues. In late April, Dr. Maholmes convened a strategic planning group that met in Bethesda, Maryland to clarify what its mission should be going forward and to advise the new branch on how it can best accomplish its mission.

At its core, pediatric injury is a huge health problem in our country and we need to assist, support and foster this branch with a vision toward its long-term success. It needs to be a highly-funded resource for research. It will take years for that vision to be realized, but it’s going to be worth the long-term ride.

– Dr. J. Wayne Meredith, Medical Advisor


EventsBuilding Our FutureOur annual fundraising banquet was held at Childress Vineyards in Lexington, N.C. on August 20. The event, co-hosted by Richard Childress and his wife Judy, was also attended by their grandsons Austin and Ty Dillon and other racing celebrities. Dinner sponsors included Caterpillar Inc., Chevrolet, Dr. Dan and Karen Couture, The Dow Chemical Company, Lucas Oil Products, Inc., Quicken Loans Inc., Okuma America, South Point Hotel and Casino, Squire, Patton and Boggs, Specialized Mobile Exhibits, University of Northwestern Ohio, WIX Filters and WESCO Distribution. Beer was provided by D.G. Yuengling & Son.

We announced our “Save Injured Kids” fundraising campaign with a goal to raise $5 million in five years. Including funds raised during the event, the Childress Institute has already received commitments of nearly $1 million. The funds raised during the campaign will field research projects to improve pediatric trauma care nationally and address traumatic injuries in youth recreation and sports.

T. Wayne Robertson Golf Tourney

The T. Wayne Robertson Memorial Fund was estab-lished in 1998 to honor the life of T. Wayne, one of the most influential figures in motorsports history. The 8th Annual T. Wayne Robertson Memorial Golf Tournament benefiting the Childress Institute was held at Tanglewood Park in Clemmons, N.C. on October 27.

The tournament raised $50,000 for our programs and had 220 attendees. This generous support highlights the close relationship and mutual respect shared by T. Wayne and Richard Childress. Please save the date for the 2015 tournament on Monday, October 26. For more information, visit twaynefund.org.

Matt Gfeller Memorial Doughnut RunThe Matt Gfeller Memorial Doughnut Run is a lighthearted 5K run/walk for the entire community to remember Matt, who was a competitive athlete, talented performer and connoisseur of tasty food. The 6th Annual Doughnut Run was held on November 15 at R.J. Reynolds High School in Winston-Salem, N.C.

The race had 805 runners and raised $46,000 for traumatic brain injury prevention, which was split evenly between the Childress Institute and the Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center at UNC-Chapel Hill.

Please save the date for the 2015 race on Saturday, November 14. For more information, please visit MatthewGfellerFoundation.org.

Learn more about our events and view more photos!





Bob Gfeller, Richard Childress and Toby Robertson

Mike and Tina Dillon, Haley and Ty Dillon, Richard and Judy Childress, and Austin Dillon


Goal #1: Sami’s Story

Five-year-old Sami was injured on a Swiss mountain farm – his abdomen was crushed between the tire of a tractor and a gate post. He immediately complained of severe abdominal pain and became very pale. At the regional trauma hospital, a CT scan revealed massive amounts of free fluid in his abdomen, which was due to bleeding of the liver, pancreas and spleen.

When Sami arrived by helicopter transport at the University Children‘s Hospital (UKBB) in Basel, Switzerland, his body was suffering from severe shock. Dr. Johannes Mayr, a pediatric surgeon, had participated only one week earlier in the Childress Institute for Pediatric Trauma webinar. Dr. Mayr and his team were able to save Sami’s life using surgical techniques learned during the webinar. Immediately after his surgery, Sami was transferred to the pediatric intensive care unit for further care.

Four weeks after his injury, Sami returned to his mountain farm home and has been well ever since. The pediatric-trauma-specific education provided by the webinar and the Childress Institute helped Dr. Mayr save Sami. According to Dr. Mayr, knowledge gained from these webinars is of considerable value, especially since it is not freely available elsewhere. It is even more valuable to the families that benefit directly.

Everyone counts on the fact that a child’s doctor or surgeon knows the best procedure in an emergency, and these webinars connect pediatric medical professionals across the world. Access to innovative techniques saves lives. Sami is one of them.

Goal #2: Brie’s Story

During a high-school field-hockey game in September 2013, near her Virginia hometown, Brie Boothby was struck in the side of her head with an opponent’s stick and blacked out.*

“The only thought in my mind was getting back in the game,” said Boothby. And despite her injury, the field-hockey player kept playing. “I thought I had to be tough. I thought I had to go back in because we were losing and I needed to support my team.”

That night, the 17-year-old felt nauseous, and began losing her memory. A trip to the doctor revealed devastating news: Boothby had sustained a serious concussion that left her with permanent brain injuries.

It took Boothby 10 months of physical therapy just to be able to stand up without falling over. Since then, Boothby said that her school work suffered, and she’s been diagnosed with ADHD. “My GPA dropped so much that I’m really anxious about college,” she said. “I’m not sure if I’m gonna get into what I’ve worked for my entire life.”

Boothby’s story is one of more than 1 million young athletes who are brought to the emergency room every year. Research has found that many young athletes are still putting themselves at unnecessary risk. Doctors can’t say if Boothby made her injury worse by continuing to play, but there are very serious risks for athletes who continue playing with a head injury.

Boothby said that until young athletes really understand the message, they’ll continue to play. Even though it’s now not what she recommends. “I think when in doubt, sit it out,” Boothby said. “And yes, it might stink sitting under the lights on the bleacher. It’s better to be safe than sorry. I mean, what is one game compared to your entire lifetime?”

*As seen on the TODAY Show

Caitlin Davis, Emily Hunter, Katie Mueda and Brie Boothby


Financial StatementsOperating AccountJuly 2013 - June 2014 Revenues

Gifts / Pedges 363,570 $Endowment Interest 210,626$Fund Raising Events 40,074$Outstanding Pledges 40,005$Sponsored Programs (143,034)$Total Revenue 511,241$

ExpensesSalaries & Benefits 278,658$Operating 25,597$

Contracts 40,000$Advertising 46,104$Marketing / Fundraising 18,319$Educational Events 7,334$Program Costs 144,857$

Travel 7,091$

Total Expenses 567,961$

Total -56,720$

General Endowment $ 4,831,211.74Budd Pediatric TraumaEducation Endowment 114,844.53$Total 4,946,056.27$

Endowment AccountsJuly 2013 - June 2014

Childress Institute for Pediatric TraumaWake Forest Biotech Place575 N. Patterson Ave., Suite 148, Winston-Salem, NC [email protected] \ 866-635-8190





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

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

childress institute for pediatric trauma - annual report 2014

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