The Pediatric Trauma department at SIUH expands with the treatment of head-injury patients, particularly those suffering from concuss ions
By Jessica Jones-Gorman • Photos By Amessé Photography
With its ever-growing youth population and increasing rate of adolescent traumatic injuries, expert pediatric surgical and trauma services have long been a priority for Staten Island residents. In response, Staten Island University Hospital and Northwell Health, with the cooperation of the pediatric physician community, has established a dedicated pediatric surgical and trauma subspecialty practice for the borough.
“Unfortunately, there is a dearth of qualified pediatric trauma centers in the New York City metropolitan area,” noted Dr. Mitchell Price, director of pediatric surgery and pediatric trauma at SIUH. “Northwell’s home base for pediatric care is Cohen’s Children’s Medical Center (CCMC) in New Hyde Park, which is at the Nassau/Queens border—basically a long distance away for most New York City residents. CCMC and Northwell Health needed a center for children in this region, and that is exactly what we intend to develop.”
Dr. Price, whose credits include stints at Robert Wood Johnson University Hospital (RWJUH), Johns Hopkins, and John H. Stroger, Jr. Hospital of Cook County, was recruited by SIUH in 2012 to help develop a dedicated children’s hospital and pediatric trauma center on its main campus.
“If your child was being treated for a specific illness or suffered some sort of serious trauma, it was often necessary in the past to go elsewhere for that care, and that was just unacceptable,” Dr. Price said. “So, as we discussed how to build a children’s hospital here on Staten Island, one of the key aspects that came up was pediatric trauma. If we could develop a designated center here in the borough, we could use that as the groundwork for our children’s hospital and continue to grow from there. It would be amazing what we could do.”
Dr. Price should know. Throughout a decades-long career in pediatric surgery, he has developed expertise in not only pediatric general surgery but also in pediatric oncology, minimally invasive surgery, and neonatal surgery for congenital disorders.
“Growing up, I was interested in architecture, science, sports… how things were put together,” Dr. Price explained. “But I always felt that medicine and anatomy were amazing. And since I was an athlete and played college basketball, I was drawn to orthopedics, and specifically sports medicine.” During medical school studies at the Pritzker School of Medicine at the University of Chicago, pediatric surgery ultimately seemed a better fit.
“Studying congenital disease taught me so much about how we’re made. Plus, I had a wonderful pediatric surgical mentor when I was a student who showed me what it was like to take a baby with a congenital anomaly, fix it, and then return that child with a new lease on life to his mother’s arms. It was awe inspiring.”
Dr. Price completed his surgical residency at New York University Medical Center and ECMO fellowship at Morgan Stanley Children’s Hospital NY Columbia Presbyterian. He completed a pediatric surgery fellowship at the Children’s Hospital–University of Colorado Health Sciences School of Medicine in Denver, but came back east in 1996 and helped develop the Bristol Myers Squibb Children’s Hospital at RWJUH, in New Brunswick, NJ, where he introduced pediatric laparoscopy and thoracoscopy and served as director of Pediatric Oncology. In 2006, he became director of Pediatric Surgical Oncology and worked in pediatric trauma at the Children’s Center at Johns Hopkins Hospital in Baltimore. He returned to Chicago in 2010 to take over as director of Surgical Education for the University of Illinois at Chicago, Department of Surgery, and was director of Pediatric Trauma at the JH Stroger Jr. Cook County Hospital. He was then recruited to SIUH and CCMC.
As a board-certified pediatric surgeon, whose practice encompasses all aspects of general surgical care, Dr. Price takes pride in the extent of his subspecialty.
“Pediatric surgery allows for a wonderful breadth of exposure,” he explained. “I have never been pigeon-holed by disease or body location, and I get to help a variety of patients, from premature infants to adolescents with a wide range of diseases. In the past, I have focused on congenital work, research, clinical work on tumors with the Children’s Oncology Group, and surgical education. My latest endeavor has been to focus on pediatric trauma.”
It was a perfect fit for SIUH, which is currently applying for its Level II pediatric trauma designation from the American College of Surgeons (ACS).
“We are constantly engaged in discussions about how to make a trauma center work in our community,” Dr. Price said, “and one of the biggest issues facing our pediatric trauma patients is head injury and concussion. The ACS looks very fondly on centers that utilize both multidisciplinary inpatient and outpatient resources to solve patient care issues, so concussions were an area in which we could make important inroads. Concussion has become such a huge thing—everyone from football players to members of Congress now have a say in the matter.”
With the assistance of Chris Sorrentino, Pediatric Trauma Program Manager, Stephanie Bovis, Injury Prevention Coordinator, and Eric Cohen, Adult Trauma Program Manager, Dr. Price has assembled a multidisciplinary team that has developed a concussion protocol for any patient who comes into the hospital with head trauma and a diagnosis of concussion. This group includes surgical staff members, as well as those from pediatric rehabilitation, pediatric intensive care unit, pediatric neurology, nursing, and the pediatric emergency room.
“The bottom line is that no one knows what to do with a child who has been concussed,” added Price. “Whether it’s a seven day-old infant who has fallen off the bed or a high school athlete injured on the field, it is necessary for each patient to be fully evaluated and treated appropriately.”
If a patient presents to the hospital with symptoms of a concussion, that child will undergo evaluation and testing and then be monitored for resolution of neurologic symptoms before being discharged. Those with a prolonged concussive syndrome will be fully evaluated and treated as needed, in hospital, by pediatric trauma surgery, pediatric rehab, and neurology. Once discharged, all patients will follow up within a week of injury for neurocognitive testing with SIUH’s pediatric rehab faculty, Dr. Rosemarie Basile and Angela DiMeglio. Any abnormalities will be assessed and interventions and follow-up will be arranged. The pediatric rehab faculty will stay in contact with home, school, and the pediatric neurology department until all symptoms have resolved and the patient is back to normal.
Dr. Price says some concussive symptoms may be subtle—the child may appear normal but may suffer from irritability, sleep disturbances, focusing issues, or a drop in grades.
“I think this trauma program will be huge for the people of Staten Island. We have the ability to make a real difference in the lives of children, and that is a very worthwhile goal.”
“Before this protocol was in place, the child’s pediatrician would be responsible for identifying these subtle abnormalities, and some local pediatricians may find it hard to recognize these symptoms,” Dr. Price explained. “Our neurocognitive and concussion specialists are specifically trained to recognize these subtleties and help children through the appropriate interventions. Now, with the proper protocol and treatments in place, these patients will not fall through the cracks.”
The Pediatric Concussion Group has also begun to work extensively on community outreach and outpatient services under the guidance of Stephanie Bovis. The group plans to go into high schools with educational material on concussions in athletes and neurocognitive baseline testing for those most at risk for the injury.
Dr. Price says a pilot study will take place in select football programs this fall, which if successful, will hopefully lead to funding for a public school study.
“Each child will receive baseline testing before participating in a sport,” he said. “If there is a head injury and possible concussion, we will have those original studies to help, in real time, compare, evaluate, and identify whether there has been any cognitive damage. If there are clear deficits, we can treat them, and this information can also help us evaluate when the child or adolescent is ready to return to the playing field.”
Programs like this exist in a number of metropolitan areas, but there are none in New York City. For Dr. Price, who has helped thousands of patients overcome daunting obstacles throughout his career, it represents a positive future and enormous opportunity for pediatrics in the borough.
“I think this trauma program will be huge for the people of Staten Island and for the entire region,” he concluded. “We have the ability to potentially make a real difference in the lives of children with concussion and head injury…and that is a very worthwhile goal.”
SIUH Pediatric Trauma/Surgery
256C Mason Avenue, 3rd Floor Staten Island, NY 10305
718.226.1850 / siuh.edu