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20160922  Paul  Deborah Bachini 4222 1200x630

Level I Trauma Center Means the Difference Between Life and Death

Paul Bachini survives being hit by a car, thanks to the only Level I Trauma Center in our region.

Category: Trauma

It seemed like any other day for Paul Bachini, who was out for his daily stroll with his wife near their Feeding Hills home.

But the day took a turn for the worse when Paul was hit by a car and sent bouncing off its hood and flying through the air, only to painfully land against a mailbox along the side of the road.

Bachini was in critical condition. He was quickly brought to Baystate Medical Center, where a team of trauma surgeons were waiting for him in the Emergency Department.


“I remember Paul distinctly. He was very unstable when he arrived. His heart rate was high and his blood pressure was quite low. He had many bruises and cuts, and he was bleeding all over his body,” says Dr. Andrew Doben.

Dr. Doben is one of six highly skilled trauma surgeons who make up the hospital’s Level I Trauma Center, the only one of its kind in western Massachusetts.

“Coming to our trauma center saved Paul’s life,” adds Dr. Doben, who also notes that Bachini was attended to by nearly every trauma surgeon while in the Emergency Department and during his first 24 hours of care.

Bachini, a retired Agawam schoolteacher, agrees. “Because of the exceptional treatment and care I received at Baystate, I have been able to carry on a pretty normal life with just a few exceptions,” he says. He no longer drives or rides his bicycle. He is also unable to read without special visual aids, because of damage to his eyes, including the optic nerve in his left eye.

With a serious pelvic fracture causing life-threatening hemorrhaging, Bachini was at risk for dying. And it’s exactly this kind of case that Baystate’s Level I Trauma Center is equipped for.


The question when Bachini arrived at Baystate’s Emergency Department wasn’t so much what was wrong with him, but what wasn’t.

“Paul had a bleed deep in his brain, massive facial fractures, and injuries all over his upper body and spine—a break on each of the levels of his spine. He also had a very serious pelvic fracture which was causing him to bleed inside, and meant he needed blood transfusions three times in 24 hours. And, he nearly lost his ear,” explains Dr. Doben.

“We quickly placed Paul on full life support and began transfusing him with blood. We rushed him to interventional radiology where we tried to stop his internal bleeding through a minimally invasive technique called angiographic embolization,” explains Dr. Doben.

“This helped to stabilize his bleeding, but only addressed his bleeding arteries. The bleeding from his veins continued and we needed to do more,” he adds.

In addition to Dr. Doben, other trauma surgeons attending to Bachini during his initial hours and recovery at Baystate were Drs. Reginald Alouidor, Eleanor Winston, and Ronald Gross, chief, Trauma, Acute Care Surgery and Surgical Critical Care.


Bachini was transported to Baystate Hospital’s intensive care unit (ICU) where he remained unstable. The next morning, he was rushed to the operating room where they tried again to control internal bleeding from his pelvic fracture. They performed a technique called preperitoneal pelvic packing, which involves placing large gauze pads into the hole that is bleeding.

“As Paul began to improve, we were able to bring him back to the operating room to remove his pelvis packing and start work on the other less-critical injuries. Over the next week, he continued to improve and was slowly removed from life support. He eventually returned to the operating room where plastic surgeons, key team members in our Trauma Services, performed facial reconstruction,” Dr. Doben explains.


After spending weeks in the ICU, Bachini spent several weeks in a rehab facility where he had physical and occupational therapy to help him to get back on his feet, literally.

“They helped me to strengthen my legs. I also needed speech therapy and had to relearn how to swallow after having a tracheotomy,” says Bachini.

“But, I have to say that the folks at Baystate were wonderful and made sure that before I even left the hospital for rehab, that I was functional and healthy enough to leave,” he adds.


Baystate Medical Center is the only American College of Surgeons-Committee on Trauma verified Level I Trauma Center in western Massachusetts.

A trauma center is specially equipped to care for adults and children after the most serious injuries, such as car crashes, gunshots or serious falls.

As a Level 1 Trauma Center, Baystate offers:

  • Care for every aspect of an injury, from prevention to rehabilitation.
  • A multidisciplinary team of doctors, nurses and other staff who are available 24 hours a day, seven days a week
  • State-of-the-art medical equipment and other specialized resources for people who need trauma care
  • A helipad equipped with an elevator that opens directly into the trauma unit
  • A three-bay resuscitation area

Trauma centers like Baystate are also required to research, to support a surgical residency program, and to respond to at least 600 major trauma cases per year. Each year Baystate’s Trauma Services cares for about 2,200 people at the hospital’s Emergency Department, which is recognized as the busiest in the entire state.


If anything at all good came out of this unfortunate circumstance, Bachini said it is his newfound understanding of the great need for blood donors and for having a supply of blood on hand at the hospital, so others like him in times of a medical crisis will live.

“I took plenty of withdrawals,” says Bachini about the many transfusions he needed throughout his stay at the hospital, especially during his initial treatment in the Emergency Department.

“As a result of my injuries, my daughter and her fiancé, Andy, have become avid donors at Baystate’s Blood Donor Center,” he adds, explaining that he cannot donate because of the accident.

It was while his daughter, Danielle, was donating blood one day that a nurse from Agawam—whose three children all had Bachini as a teacher—recognized her name and asked if she thought her father might be interested in telling his story at the hospital’s upcoming Blood Donor Appreciation event.

Naturally, Bachini agreed. “To stand in front of those donors and thank them for what they do, giving of themselves so others can live, well, it was very touching. I got to meet with some of them and thank them personally for what they do. It is important as anything else that goes on in the hospital,” he says.

But, that wasn’t the first time he had returned to the hospital to express his thanks. “After I left rehab and life began to return to somewhat normal for us, we returned to Baystate with plates of cookies in hand to thank and speak with the physicians, nurses and other medical staff members who were so instrumental in my care. I wanted to let them know how much I appreciated them saving my life,” says Bachini.