{"@context":"http://iiif.io/api/presentation/3/context.json","id":"https://marmia.aviaryplatform.com/iiif/ms3jw88h73/manifest","type":"Manifest","label":{"en":["Howard Champion 2, circa 1988"]},"logo":"https://d9jk7wjtjpu5g.cloudfront.net/organizations/logo_images/000/000/053/original/cropped-marmia-logo-copy1.png?1586173104","metadata":[{"label":{"en":["Source Metadata URI"]},"value":{"en":["https://marmia.libraryhost.com/repositories/2/archival_objects/15134"]}},{"label":{"en":["Date"]},"value":{"en":["circa 1988 (Creation)"]}},{"label":{"en":["Description"]},"value":{"en":["Be advised that this video may contain sensitive, triggering, and offensive language and content. (Content warning)","Digitized with funding provided by the Council on Library and Information Resources' \"Digitizing Hidden Special Collections and Archives: Amplifying Unheard Voices\" grant program. (Funding note)","Raw footage of an interview with Dr. Howard Champion, director of the MedStar shock-trauma unit at the Washington Hospital Center. (Scope and Content Note)"]}},{"label":{"en":["Format"]},"value":{"en":["1 U-matic"]}},{"label":{"en":["Identifier"]},"value":{"en":["WJZ-UNKN-070-001 (Identifier)"]}},{"label":{"en":["Series Title"]},"value":{"en":["Unidentified Footage"]}}],"summary":{"en":["Be advised that this video may contain sensitive, triggering, and offensive language and content.","Digitized with funding provided by the Council on Library and Information Resources' \"Digitizing Hidden Special Collections and Archives: Amplifying Unheard Voices\" grant program.","Raw footage of an interview with Dr. Howard Champion, director of the MedStar shock-trauma unit at the Washington Hospital Center."]},"provider":[{"id":"https://marmia.aviaryplatform.com/aboutus","type":"Agent","label":{"en":["MARMIA"]},"homepage":[{"id":"https://marmia.aviaryplatform.com/","type":"Text","label":{"en":["MARMIA"]},"format":"text/html"}],"logo":[{"id":"https://d9jk7wjtjpu5g.cloudfront.net/organizations/logo_images/000/000/053/original/cropped-marmia-logo-copy1.png?1586173104","type":"Image"}]}],"thumbnail":[{"id":"https://d9jk7wjtjpu5g.cloudfront.net/collection_resource_files/thumbnails/000/267/654/small/open-uri20250314-1605153-f1kbwi_1741980162.jpg?1741980163","type":"Image","format":"image/jpeg"}],"items":[{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267654","type":"Canvas","label":{"en":["Media File 1 of 2 - open-uri20250314-1605153-f1kbwi.mp4"]},"duration":1250.367,"width":640,"height":360,"thumbnail":[{"id":"https://d9jk7wjtjpu5g.cloudfront.net/collection_resource_files/thumbnails/000/267/654/small/open-uri20250314-1605153-f1kbwi_1741980162.jpg?1741980163","type":"Image","format":"image/jpeg"}],"items":[{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267654/content/1","type":"AnnotationPage","items":[{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267654/content/1/annotation/1","type":"Annotation","motivation":"painting","body":{"id":"https://aviary-p-marmia.s3.wasabisys.com/collection_resource_files/resource_files/000/267/654/original/open-uri20250314-1605153-f1kbwi.mp4?1741980160","type":"Video","format":"video/mp4","duration":1250.367,"width":640,"height":360},"target":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267654","metadata":[]}]}],"annotations":[{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267654/transcript/77502","type":"AnnotationPage","label":{"en":["AUTO_TRINT_WJZ-UNKN-070-001_FFV1.ia.mp4 [Transcript]"]},"items":[{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267654/transcript/77502/annotation/1","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003eSpeaker 1:\u003c/strong\u003e Are you rolling? Don't roll for a second. Oh, you're just doing barges.","format":"text/plain"},"target":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267654#t=8.49,11.55"},{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267654/transcript/77502/annotation/2","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003eSpeaker 2:\u003c/strong\u003e This is serious business.","format":"text/plain"},"target":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267654#t=14.97,15.71"},{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267654/transcript/77502/annotation/3","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003eSpeaker 1:\u003c/strong\u003e Oh, what, it's, um...","format":"text/plain"},"target":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267654#t=16.11,18.01"},{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267654/transcript/77502/annotation/4","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003eSpeaker 3:\u003c/strong\u003e Did you un-poise your little tongue?","format":"text/plain"},"target":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267654#t=18.83,19.79"},{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267654/transcript/77502/annotation/5","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003eSpeaker 1:\u003c/strong\u003e Okay, thank you.","format":"text/plain"},"target":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267654#t=20.01,20.75"},{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267654/transcript/77502/annotation/6","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003eSpeaker 2:\u003c/strong\u003e Uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh, uh","format":"text/plain"},"target":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267654#t=21.42,23.24"},{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267654/transcript/77502/annotation/7","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003eSpeaker 1:\u003c/strong\u003e How are you doing? Okay, let's go straight to the heart of the issue. Are there people dying needlessly in America?","format":"text/plain"},"target":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267654#t=22.88,31.63"},{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267654/transcript/77502/annotation/8","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003eSpeaker 2:\u003c/strong\u003e Yes, we've had a number of studies in the past 10 years which have been aimed at trying to document the need for improved trauma care. And a lot of those studies have focused on preventable deaths. There have been about 50 studies. And wherever people have looked at this and had And thank you for joining us. Physicians look very carefully at those who die of injury in the community. They found on average 19.3%, in other words, nearly one person in five dying needlessly of those injuries. So that would equate with probably 20,000 to 25,000 people a year in the United States dying unnecessarily of injuries that they receive.","format":"text/plain"},"target":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267654#t=33.43,78.39"},{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267654/transcript/77502/annotation/9","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003eSpeaker 3:\u003c/strong\u003e I mean, that's a sizable number of people. It would seem that there would be some sort of outcry. I mean.","format":"text/plain"},"target":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267654#t=79.44,84.62"},{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267654/transcript/77502/annotation/10","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003eSpeaker 2:\u003c/strong\u003e Well, if the figures were known and people could get energized about it, perhaps there would be. But again, there's a tremendous amount of apathy. There's apathy in the professional community. There is apathy in the political community. And there is apathy in society in general with regard to injury for a variety of reasons. Thanks for watching!","format":"text/plain"},"target":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267654#t=85.99,107.91"},{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267654/transcript/77502/annotation/11","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003eSpeaker 4:\u003c/strong\u003e You talked about the public apathy. Why is there apathy in the medical community?","format":"text/plain"},"target":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267654#t=108.91,112.23"},{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267654/transcript/77502/annotation/12","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003eSpeaker 2:\u003c/strong\u003e Medical community, part of the problem is that if you're a really good doctor, there's something better for you to do than get up in the middle of the night and treat people who are injured. And that's pervades somewhat. A lot of the patients don't pay for their care, particularly in the urban environments where the injury population is made up not only of the automobile accident population but also of those that are injured from knife wounds or gunshot wounds and this group of patients doesn't pay by and large for the care provided either to the hospital or to the physicians. The fact that it is a Internal disease is another factor, injury tends to occur at night. at weekends and on holidays. If you are an elective physician or surgeon, you tend to want to work routine hours like most doctors would, and you would like to attend your office practice or do your surgery during the day. If you spend all night up looking after some person who A, can't pay, and B, might be abusive with it, then you suddenly get tired of that as soon as you develop a mature practice. Thank you very much. It is, because it's a nocturnal disease, it's not the sort of disease that you can rally a lot of support for in the medical community. You find that physicians, when they are just out of training, will be available for this type of call to take care of emergencies. But as their practice matures, they become more established, then they tend to be less enthusiastic about it. the training in care of injured. patients has been pretty poor. It's only in the past five years, as a result of Don Trunke's attempts to focus on the inadequacies of training, that surgeons are being supplied with better, more structured training in how to care for these patients. But outside the surgical disciplines and outside the emergency medicine disciplines, there's very little training. Even if you go to medical school today, you will not hear about the epidemiology of the disease. It will not be discussed as a disease. It will be discussed just as an add-on to something else. You get these injured patients in the emergency department from time to time, and there are these various approaches to treating them. It's not treated as a disease like cancer is. It is not treated in a manner that people think about prevention and about rehabilitation getting these individuals back to work. So from an educational point of view, from an economic point of view, there are many many things that will produce professional apathy or ignorance.","format":"text/plain"},"target":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267654#t=113.04,296.63"},{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267654/transcript/77502/annotation/13","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003eSpeaker 3:\u003c/strong\u003e But at the same time, there's like at Jacksonville, seven hospitals call themselves trauma centers. I mean, there's a lot of overbuilding going on, too.","format":"text/plain"},"target":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267654#t=297.79,307.25"},{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267654/transcript/77502/annotation/14","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003eSpeaker 2:\u003c/strong\u003e Well, that's a competition between hospitals. Comes into whether a patient can get the right care for his injuries. The American College of Surgeons in the mid-70s identified criteria by which a hospital could specify its commitment to 24-hour availability for care of people with severe injuries. these criteria have been revised in 1979 and again in 1986, and they are the cornerstone by which institutional commitment to trauma care is identified. When an institution meets these criteria, it's usually given the accolade of a trauma center, and trauma centers have become politically desirable things for communities to have. Hospitals are very keen to compete with one another, and they are keen, in many instances, to have this appellation attached to them, be called trauma centers. So if one hospital wants to be called a trauma center, you'll often find that hospital administrators in another hospital will decide that they don't want the patients all to be channeled there. They want a trauma center designation as well. One of the reasons that the development of trauma care has been. uh... impeded is that we are basically saying that we want a restrictive practice of medical care uh... we're basically saying that uh... there are only a certain number of severely injured persons in the united states that about one in five of them will die if they don't get appropriate care and therefore we need a specialized system of care for these individuals uh... there are about six thousand five hundred hospitals in the united states At the present time, there are about 150 trauma centers. uh... we need just a small number of trauma centers somewhat more than a hundred and fifty uh... but we're asking communities to say take people with severe injuries and direct them to a special system of care a restricted system of care so that only people with severe injuries go or so that people with severe injuries only go to this group of hospitals and are cared for by this group of patients It's a restrictive practice. Hospitals don't like to be restricted. Physicians don't like to be restricted. And even though the patient care needs are very clearly documented in patients with severe injury, it is still meeting resistance in the medical and hospital community because it is restricting access of a small group of patients to certain hospitals and physicians. Thanks for watching!","format":"text/plain"},"target":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267654#t=308.37,481.42"},{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267654/transcript/77502/annotation/15","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003eSpeaker 5:\u003c/strong\u003e Yeah, but on the one hand, it's like you just say, surgeons don't want to do it, it costs too much money, you have all this, and on the other hand, well, let's all be one because of good PR. I mean...","format":"text/plain"},"target":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267654#t=481.8,491.56"},{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267654/transcript/77502/annotation/16","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003eSpeaker 2:\u003c/strong\u003e Well, that's human nature, I'm afraid. If you tell somebody they can't do something, they want to do it. And if you tell people in the health care profession they can't do something or shouldn't be doing something, they will want very, very good reasons for not doing it. If you ask them to do it in the middle of the night and tell them that the patient is an indigent who can't pay and who's got a stab wound to the belly, Thank you. Thank you. Then you might not be afforded the prompt response that you would expect to find From the competition that you will find at a meeting nine o'clock the following morning With regard to who should be caring for these patients","format":"text/plain"},"target":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267654#t=491.99,528.05"},{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267654/transcript/77502/annotation/17","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003eSpeaker 6:\u003c/strong\u003e Who's a typical preventable death? Give me a rundown of who that is.","format":"text/plain"},"target":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267654#t=530.749,535.91"},{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267654/transcript/77502/annotation/18","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003eSpeaker 2:\u003c/strong\u003e Well, a typical preventable death is a young – I'll give you two examples, if I may. One is a young teenager who's been out to a party, had a few drinks and is on the way home driving, involved in an automobile accident late on a Saturday night, early on a Sunday morning, probably in a community some distance away from a major medical center, maybe, let's say, 50, 60 miles outside a big city. in a rural community and has an accident, is fairly severely injured because he was sitting behind the steering wheel, has taken to a local hospital in the middle of the night where the ability to assess these multiple injuries is not necessarily all there when it is needed. I'm looking at here's somebody who, let's presume that they're severely injured, that they're in the process of dying. Thanks for watching! We know that the likelihood of them being dead within four hours if they're going to die is very significant. And yet, they will go into a hospital which is geared down. Sunday morning, you're not going to find a hospital maximally able to marshal its resources. And if you're looking for x-ray, blood bank, operating room, surgeons, et cetera, if they're not there, they can take some time to get together. Meanwhile, the patient is still dying. It is quite possible in that sort of environment for the patient's significant injuries, which are fixable in optimum circumstances, to go past the point of no return. They can be bleeding from their liver. They can have severe injury to a major blood vessel, which can go on to bleeding, and they'll die of shock. They can have bleeding inside their skull. and that can compress the brain so that they have got no chance whatsoever of surviving without either major disability or they die. Those two options are the only ones that are available to them at about four hours following injury. Many of these hospitals now have developed relationships with trauma centers and they are focusing on identifying those with severe injuries and knowing that that community doesn't necessarily have all of the resources maximally geared to provide care at three o'clock in a Sunday morning. They will transport the patient to a facility that has those capabilities 24 hours a day, 365 days a year.","format":"text/plain"},"target":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267654#t=538.04,694.99"},{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267654/transcript/77502/annotation/19","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003eSpeaker 7:\u003c/strong\u003e Tell me a little bit more about the issue. I mean, it seems to me that the golden hour is sort of a misnomer.","format":"text/plain"},"target":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267654#t=695.28,699.62"},{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267654/transcript/77502/annotation/20","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003eSpeaker 2:\u003c/strong\u003e Well, the Golden Hour really is essentially a marketing tool to try and draw attention to the needs of the patient who is dying of injury. It doesn't have any real basis in pathophysiology. The patients who die of injuries will fall into three groups. The first group are those that die very acutely following injury. And they... Most of those people will die within a period of four to six hours. Many of them die very soon following injury. Half of those who die from injury in the United States will die before they get to hospital care. And so we really need to do something about our pre-hospital systems. Of those that are going to die in hospital, then about 60% will die within the first four hours. if they're going to die of bleeding, about 40% will die. if they're gonna, in the first four hours, if they're gonna die from head injury. For some people, an hour is too long. I mean, an hour is curtains, because they're bleeding so vigorously or they've got so many problems with them. For others, then they deteriorate a little bit more slowly, but all the time, certain cells and certain organs of the body are dying. So... uh... the bottom line with the acute death group which comprises the vast majority of those who die from injury is that we need to uh... treat people as soon as possible and as energetically as possible following injury the vast majority of injury deaths occur acutely there are two other groups of deaths those that occur a few days later and those a few weeks later but in terms of Where we should be putting our resources, we need to pile our resources up as soon as possible following injury. That's where we can show a percentage reduction in the overall mortality from injury. If we put maximum resources as close to the time of injury as possible, we will see some results, because that's where the vast majority of preventable deaths are likely to occur. Can you hear me?","format":"text/plain"},"target":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267654#t=701.05,837.3"},{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267654/transcript/77502/annotation/21","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003eSpeaker 4:\u003c/strong\u003e Let's talk a little bit about Kenny Perkins. Okay. Should he have come here?","format":"text/plain"},"target":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267654#t=837.5,841.54"},{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267654/transcript/77502/annotation/22","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003eSpeaker 2:\u003c/strong\u003e Yes. Can he... We can use his name, can we? He's given permission to us. He has. 46. Let me just see if I can remember the circumstance of this for a quick second. Can you remember? What was he doing? Was he robbing somebody or was he just walking along the street minding his own business?","format":"text/plain"},"target":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267654#t=843.25,866.63"},{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267654/transcript/77502/annotation/23","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003eSpeaker 1:\u003c/strong\u003e was just walking home.","format":"text/plain"},"target":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267654#t=866.95,867.63"},{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267654/transcript/77502/annotation/24","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003eSpeaker 2:\u003c/strong\u003e Okay, all right, okay, fine.","format":"text/plain"},"target":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267654#t=868.03,871.95"},{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267654/transcript/77502/annotation/25","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003eSpeaker 6:\u003c/strong\u003e So, tell me about why Kenny wrote the book.","format":"text/plain"},"target":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267654#t=874.14,876.74"},{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267654/transcript/77502/annotation/26","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003eSpeaker 2:\u003c/strong\u003e Well, Kenny was a homeless person here in Washington. Sorry, is still, I believe, a homeless person here in Washington who was stabbed last November. He wasn't doing anything particularly to incite anybody. In fact, was walking home. And he was stabbed multiple times in the chest, abdomen, and arms. And he had multiple injuries. in these areas and was brought here as a result of being identified by the paramedics as somebody who could have life-threatening injuries because of the location of the stab wounds over the heart, over the chest, and over the upper abdomen. And he was with us for a few weeks following those injuries. His liver was lacerated, both of his lungs were collapsed. His right lung was lacerated. For a brief period of time, there was a suspicion he might have had a stab wound of the heart, but that was rapidly excluded, and he had a stab to a major vein in his neck. So he had plenty of reason to be in a trauma center, and he certainly required multiple surgical procedures within a very short time of admission. He needed the neck exploring and the bleeding from the jugular vein stopping. He required exploration of his abdomen and bleeding in the liver had to be stopped. And he also had to have an exploration of his chest for the bleeding there.","format":"text/plain"},"target":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267654#t=877.7,979.92"},{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267654/transcript/77502/annotation/27","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003eSpeaker 4:\u003c/strong\u003e Now, how do paramedics know to bring them?","format":"text/plain"},"target":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267654#t=980.64,983.4"},{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267654/transcript/77502/annotation/28","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003eSpeaker 2:\u003c/strong\u003e Well, for a number of years we've had triage guidelines, which are a set of decision rules to identify people at risk of dying, and that's sometimes not very easy in the pre-hospital phase of care. But this is one of the areas that we've been researching very vigorously to try and improve the skill by which we can identify people who are at risk of dying in the first few hours following injury. With penetrating injury it's a little bit easier because we've got holes and that does provide us with some guide as to which organs might be injured and any significant Torsal injury or penetrating injury to the chest, abdomen, neck... we would like to see in a trauma center, particularly if it's a ballistic injury from a bullet. With blunt injury, it's a bit more difficult because the external evidence of significant injury to the chest and abdomen can be initially quite minimal. And so we have to work on the physiological status of the patient, whether their blood pressure is normal or not, whether they're fully conscious. And somehow we've got to identify those that have got significant organ injury. uh... that is at risk of killing the patient even though they are normal immediately following the accident uh... from a physiological point of view that can be very difficult and uh... we uh... we look to trying to identify how much force has been applied to the body uh... and whether that uh... correlates in most circumstances with a high risk of death but it's a big challenge to rapidly identify this patient from that one uh... with injuries For example, there are... about um... Let me just think of these statistics a second. I think there are about, there are 3.7 to 4 million people each year injured in automobile accidents. And there are about a quarter of a million of those, no, sorry, that's wrong, 3.7 to 4 million people injured in automobile accidents each year injured. And about 170,000 of those. have got life-threatening injuries. So we have to pick out a small proportion of those that are injured. Of those with significant injuries, about 50,000 die. So once you're in that group of being severely injured, you've got a one in three chance of dying, on average, in the United States. So how do we rapidly identify them is a significant challenge. Severe injury in the United States is not very common, but the mortality associated with it is very, very common. uh... it's very high uh... we're talking about a thirty percent risk of dying once you fall into that category of people with severe injuries and uh... there are nearly four million people hospitalized each year for injury in the united states so we're just talking about a small fraction of those less than ten percent uh... the population at risk of dying","format":"text/plain"},"target":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267654#t=984.4,1190.3"},{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267654/transcript/77502/annotation/29","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003eSpeaker 7:\u003c/strong\u003e I mean, Kenny's trial square was 14. Do you want to change this? I figured.","format":"text/plain"},"target":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267654#t=1190.97,1195.23"},{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267654/transcript/77502/annotation/30","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003eSpeaker 2:\u003c/strong\u003e Am I giving you too long answers? Are my answers too long to these guys? of these things.","format":"text/plain"},"target":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267654#t=1196.57,1200.26"},{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267654/transcript/77502/annotation/31","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003eSpeaker 1:\u003c/strong\u003e It's a problem with this whole piece because of this. Watch your microphone.","format":"text/plain"},"target":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267654#t=1201.34,1203.78"},{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267654/transcript/77502/annotation/32","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003eSpeaker 7:\u003c/strong\u003e thing leads to a","format":"text/plain"},"target":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267654#t=1204.97,1205.77"},{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267654/transcript/77502/annotation/33","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003eSpeaker 1:\u003c/strong\u003e If you want to, you can just unplug it and then go walking around.","format":"text/plain"},"target":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267654#t=1205.72,1207.5"},{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267654/transcript/77502/annotation/34","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003eSpeaker 2:\u003c/strong\u003e Let me just get my hat on too. Where's that coffee?","format":"text/plain"},"target":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267654#t=1206.95,1209.51"}]},{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267654/transcript/77502","type":"AnnotationPage","label":{"en":["English [Transcript]"]},"items":[{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267654/transcript/77502/annotation/35","type":"Annotation","motivation":"subtitling","body":{"type":"TextualBody","value":"https://d9jk7wjtjpu5g.cloudfront.net/file_transcripts/associated_files/000/077/502/original/trint_WJZ-UNKN-070-001_FFV1_transcript.vtt?1742308207","format":"text/vtt","language":"en"},"target":"https://d9jk7wjtjpu5g.cloudfront.net/file_transcripts/associated_files/000/077/502/original/trint_WJZ-UNKN-070-001_FFV1_transcript.vtt?1742308207"}]}]},{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267655","type":"Canvas","label":{"en":["Media File 2 of 2 - open-uri20250314-1605153-lzwnr0.mp4"]},"duration":1250.367,"width":640,"height":360,"thumbnail":[{"id":"https://d9jk7wjtjpu5g.cloudfront.net/collection_resource_files/thumbnails/000/267/655/small/open-uri20250314-1605153-lzwnr0_1741980237.jpg?1741980238","type":"Image","format":"image/jpeg"}],"items":[{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267655/content/1","type":"AnnotationPage","items":[{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267655/content/2/annotation/1","type":"Annotation","motivation":"painting","body":{"id":"https://aviary-p-marmia.s3.wasabisys.com/collection_resource_files/resource_files/000/267/655/original/open-uri20250314-1605153-lzwnr0.mp4?1741980235","type":"Video","format":"video/mp4","duration":1250.367,"width":640,"height":360},"target":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144799/file/267655","metadata":[]}]}],"annotations":[]}]}