Howard R. Champion

Trauma, Critical Care Surgeon

FRCS, (Edin), (Eng), DMCC FACS

Learnt 5 main lessons at the Acci:

  • The team system – the three teams on, off (elective surgery) and backup each with full compliments of consultants (attendings), senior and junior trainees
  • Disciplined multidisciplinary management under a “team leader”
  • Early integration of post mortem pathology to the clinical experience – thanks to Simon Sevitt 
  • Separation of serious injured from the walking wounded – the ambulance used to back into the resuscitation area of the Major Injuries Unit (MIU) where patients where immediately subjected to major resuscitation procedures prior to operative care as necessary
  • The leadership role of the consultant e.g. PSL and others Badger et al
  • Had a period at the Royal Infirmary and University of Edinburgh
  • 1973 moved to the Shock Trauma Unit at the University of Maryland in Baltimore – “I witnessed R Adams Cowley screaming at a hoard of individuals surrounding trauma patients that had been admitted directly from the heliport or ambulance to an intensive care unit bed without any structural process to guide or secure their care.  As a result of my experience at the Birmingham Accident Hospital I was able to institute the team system, roles for team members, cross disciplinary training and quality management techniques and tactics. I was also able to design and build a resuscitation area with an adjacent operating room.”
  • 1975 he brought these basic structures to Washington, DC where he ran a trauma centre for about 20 years.
  • In the late 70s/ early 80s many trauma centres around the US adopted these techniques – including the Ryder Trauma Centre at the University of Miami thanks to Bob Zeppa, then Chairman of Surgery and a new Shock Trauma Centre at University of Maryland.
  • In Washington he placed the helipad and ambulance ramp with direct access to the resuscitation bays and operating rooms as at the Birmingham Accident Hospital and at a separate entrance from the walking wounded/emergency department.
  • The data from the United States show a continued reduction in in-hospital mortality, as a result a trauma centre implementation across the country in the 80’s.  
  • He was a member of the Committee on Trauma of the American College of Surgeons and helped instantiate the standards he’d acquired from the Birmingham Accident Hospital into the American College of Surgeons Guidelines. 
  • His experience as an SHO at the Accident Hospital had profound impact on his career and probably trauma care throughout the world. He continued to propagate his US experience into many other countries and through the International Association for Trauma Surgery and Intensive Care.
  • He founded which I founded the International Association for Trauma Surgery and Intensive Care under the guidance of Martin Allgower, Secretary General of the International Society of Surgery.  
  • Enjoyed Gissane’s company over meals at the Edgbaston Golf Club