An Accident That Nearly Took Everything: Care Excellence With OU Health's Level I Trauma Center

Screeching tires. Metal against flesh. Darkness.

When Andrew Reyes woke up lying in the street on the afternoon of January 3, a police officer was standing over him. He was badly hurt but didn’t yet know how serious it was.

“I went to go get an energy drink across the street,” Andrew said. “As I was crossing …, I guess that was it. The next thing I remember is the police officer standing above me asking questions.”

Andrew’s memory of what happened right after he was hit is unclear. After being knocked out, he briefly woke up, confused and not aware of how badly he was injured. He thought he could get up and walk back to work, a behavioral health center in Oklahoma City.

"I said, ‘I need to go back to work.’ The officer says, 'No, stay right there. We gotta get you to OU Health.' And that's when I knew it was serious," Andrew said. The mention of OU Health, known throughout the region for handling the most critical cases, served as his first indication that his injuries were potentially life-threatening.

Paramedics rushed Andrew to OU Health's Level I Trauma Center, the state's only American College of Surgeons-verified Level I trauma facility, where a team of specialists stood ready.

The Golden Hour

When someone is badly hurt, like Andrew, every minute matters. The care patients get during the first hour after a serious injury is especially important. This short window of time is called “the golden hour.” It’s when fast treatment can save a life.

When Andrew got to the emergency room, the trauma team was ready. This team is trained to quickly find and treat life-threatening injuries. The trauma team includes trauma surgeons, emergency medicine physicians, anesthesiologists, ER and operating room nurses, radiology technicians, and respiratory therapists. Later, physical and occupational therapists help patients heal, and social workers and chaplains support the patient and family.

“We are easily able to quickly evaluate, diagnose, and begin treating the patients and their injuries,” said trauma surgeon Dr. Celia Blair, M.D., FACS, assistant professor in the Department of Surgery, Division of Trauma and Acute Care Surgery at the University of Oklahoma College of Medicine. “We have short response times to help ensure that all of our patients are getting appropriately treated in that ‘golden hour.’”

She likens the team to an orchestra, where every person plays their part at just the right moment.

While Andrew was being treated, his mother, Del Reyes, was going about her evening, unaware of her son’s accident. Then she got a call from the hospital.

“The doctor in the ER called from the trauma room and told us that he was in an accident,” Del said, the memory still vivid.

She rushed to the hospital and waited, not knowing if her son would survive the night.

A Long List of Injuries

Andrew had many serious injuries:

• Open leg fracture – the bone was sticking through the skin
• Broken tibia and fibula – the two bones in his lower leg
• Broken wrist
• More than a dozen broken ribs
• Fractures in his spine
• Broken nose
• Collapsed lung
• Cuts to his spleen, liver, and kidney
• Mesenteric contusion – a deep bruise to the tissue holding the intestines
• Dislocated arm
• Scrapes, bruises, and swelling all over his body

These injuries affected almost every system in Andrew’s body. The open leg fracture raised the risk of infection. Internal bleeding put his blood pressure and oxygen levels in danger. His many broken ribs made it hard for him to breathe.

Catheren Miller, the trauma program social worker at OU Health and program coordinator for the Trauma Survivors Network, has seen many serious cases. Even she was shocked by how badly Andrew was hurt.

“At one point, we didn’t think he was going to survive,” she said. “He was going downhill.”

The Orchestra of Trauma Care

Dr. Blair likens the trauma team to a finely tuned orchestra, with each specialist playing their part at precisely the right moment.

"When critical cases such as Andrew's arise, the team is always ready and available no matter what day or time that the patient arrives," she said. "Also, throughout their care, as Andrew had to experience, that 24/7 presence is always maintained so when patients are critically ill, we are able to continue to offer very complex care both in our ICUs and operating rooms."

The distinction of being the only American College of Surgeons-verified Level I Trauma Center in Oklahoma isn't merely a title; it represents a commitment to maintaining the highest standard of trauma care available anywhere.

Del witnessed the rapid response of the trauma team firsthand, noting how quickly they identified and addressed emerging threats.

"After just a few moments of being in there, his blood pressure just kind of dropped, and the nurses were so on it," she said. "They gave him blood right then and there. They reacted quickly, responding efficiently and effectively. The quality of care was exceptional and high caliber. Really top-notch nursing.”

His Fight to Stay Alive

With injuries as serious as Andrew’s, deciding how and when to treat each one is very important. The trauma surgeon leads that plan, starting with what’s most urgent.

Andrew’s first surgery took place the day after the accident, on January 4. The surgeon repaired the open leg fracture. Plates were also attached to his broken ribs to help them heal correctly and make it easier for him to breathe.

But not everything went as scheduled.

“On day three, when he had the wrist surgery planned, he could not come off the vent [breathing machine],” said Del.

Needing to stay on the breathing machine caused more problems. Andrew was given a breathing tube and medicine to keep him asleep for most of January. Doctors tried several times to remove the breathing tube, but his body wasn’t ready. His condition got worse. He developed a collapsed lung, pneumonia, and acute respiratory distress syndrome — a serious lung problem that can happen after a major injury.

“His lungs were very, very thick and fibrotic [stiff with scar tissue],” explained Del. “It was a very scary time for Andrew... they had to prone him four times …. It was a life-threatening situation.”

To help Andrew breathe, the team turned him on his stomach — a method called proning. It helps more air reach different parts of the lungs.

“During the proning process, the nurse manager was closely involved in finding the best position and comfort while maintaining skin integrity and keeping tubes in place,” Del said. “This was not easy as Andrew is 6 feet tall and well over 270 pounds at that time [which added to the physical challenge of repositioning him safely]. I was very appreciative of that.”

A Team Approach to Healing

The trauma team’s care goes far beyond the emergency room and includes support for families, too.

“We recognize the importance of everyone on this team,” Dr. Blair said. “It may even be surprising to some that chaplains are part of this team, but they are able to help quickly notify families and help gather vital information, such as medications, that may need to be quickly addressed when the patients are unable to give us that information on their own.”

A Level I Trauma Center is distinguished by the seamless integration of multiple disciplines working toward the patient's recovery. Del observed this coordination firsthand during her long vigil at Andrew's bedside.

"I really was impressed to see that kind of teamwork. I witnessed high-quality professionalism," Del said. "The way they talk to each other, like, 'thank you' and 'I've got you.' They truly, truly cared about taking care of Andrew together. It was like a collaborative effort. He had his nurse, but, man, the whole unit was his nurse. They are definitely patient-centered. Empathy in action."

This teamwork extends beyond the ICU to encompass the full spectrum of trauma recovery. Miller, as the trauma program social worker, represents another dimension of the comprehensive care model that sets Level I centers apart from other facilities.

"When it comes to all of our trauma patients that we bond with, they are interacting with the physicians a little bit every day. It's different physicians every week, different APPs, their nurses change out. I'm the constant," Miller said, highlighting her unique role in providing continuity throughout the recovery process.

Unlike smaller hospitals where mental health considerations might be addressed only after physical stabilization, if at all, OU Health integrates psychological support directly into its trauma care model. This holistic approach of addressing not just the broken bones and damaged organs but the whole person exemplifies the philosophy that guides OU Health's trauma program. It recognizes that true healing encompasses physical, emotional, and psychological recovery, all of which must proceed in parallel.

Beyond Physical Recovery

For Andrew, the emotional toll of the accident was just as heavy as the physical pain. He had a history of anxiety and depression, and now he faced the loss of his independence and a future full of unknowns.

“His number one concern was his job,” Miller said. “He was worried he was not going to be able to continue it.” She reassured Andrew that his injuries weren’t permanent and that healing would come.

His worry wasn’t just about income. Andrew's job at a rehabilitation center was deeply personal. He had once battled addiction himself and now found meaning in helping others through it.

"I work at a rehab. The reason I got the job was I been in addiction myself, been through rehabs myself," Andrew said about his determination to return to work. "I've been through a lot of stressful situations that have brought me up to this part of my life."

Del, who stayed by Andrew’s side every day, was also looked after by the team.

“One day, the ICU trauma director walked into my room,” Del said. “She asked me, ‘How are you doing?’ She wanted to make sure that I was taking care of myself, that I was eating and sleeping. I was so impressed with that. She reminded me that it was important for me to eat well, sleep well, and take care of my physical and mental well-being… I will be forever grateful.”

A Remarkable Recovery

After weeks of intensive care and multiple surgeries, Andrew began to improve. The changes came gradually, then momentum gathered. Miller remembers the moment she realized Andrew was turning a corner.

“I came back after the weekend and … he’s extubated [off the breathing machine],” Miller said.

Soon after, Andrew was walking the hospital halls with help from his physical and occupational therapists.

“I was stunned,” Miller said, “but he’s like, ‘Hey, no big deal.’”

By mid-February, Andrew was well enough to go home. He’s still recovering with physical therapy and more surgeries, including a recent skin flap procedure for his leg. But he is facing it all with the same strength that’s carried him through the hard times.

“I’m just going day by day,” Andrew said. “My endurance is a little off. My muscle strength is weak. So I’m just trying to do physical therapy and just trying to get better.”

Andrew’s employer has supported him through it all, keeping his job open and ready for his return.

“I still have my job. They want me to come back in due time,” he said.

OU Health — Oklahoma’s Leader in Trauma Care

OU Health University of Oklahoma Medical Center in Oklahoma City is the state’s only Level I Trauma Center designated by the American College of Surgeons Committee on Trauma. Oklahoma Children’s Hospital OU Health is the only ACS-verified pediatric Level I Trauma Center. This means OU Health provides the highest level of trauma and emergency care available.

“To maintain this verification is a lot of work,” said Dr. Blair. “We do this because we are passionate about trauma and feel honored to be able to take care of patients like Andrew.”

Oklahoma’s paramedics, ambulance services, and hospitals work together through a statewide trauma care system to get the most seriously hurt patients to the Level I Trauma Center at OU Health as fast as possible.

OU Health is also a member of the Trauma Survivors Network, a national program that helps people recover and rebuild their lives after traumatic injuries.