Original crew members reminisce as AirCare celebrates 15 years

THE UnIvErSITy oF MISSISSIPPI MEDICal CEnTEr
Flying
QUARTET
Original crew members
reminisce as AirCare
celebrates 15 years
airCare, UMMC’s helicopter
transport service, turned 15
this month. The first airCare
helicopter made its maiden
flight on Feb. 2, 1996.
a lot can happen in 15 years. Hair
can fall out, joints stiffen and eyes dim.
But some things stay put.
Four members of the original airCare
crew are still on the job. They know
each other better than they know
members of their own families. They
depend on each other on flights that
can take them to both ends of the
state during almost any kind of weather
carrying and caring for a critically
ill patient.
ConTInUED on PagE 3 Ò
February 7, 2011
From left, Todd Perry,
Bo Sullivan, Cathy
Delaney and Jamie
Miller
PT students visit Capitol p. 2 Dr. Evans, Taste of U co-chair p. 4 DIS on the move p. 6

2
CENTERVOICE
CEnTErVIEW | February 7, 2011
STUDENT STUDENT LOBBY LOBBY
Future physical therapists gain experience advocating at Capitol
by Matt Westerfield
P
hysical therapy student Ellen Clarke has a front-row
view of state politics, literally. With a senator for a father,
she has personally watched the political process
unfold from the floor of the Senate chamber.
And now, her classmates have gotten their own taste of
politics after visiting the state Capitol to get a little practice in
advocating on behalf of their future profession.
On Jan. 27, the entire first- and second-year classes spent
the morning in the Capitol rotunda participating in the Mississippi
Physical Therapy Association’s Legislative Day 2011. Along with
MPTA members, the students offered blood-pressure checks
and balance and grip-strength tests to passing lawmakers,
using the activities as a conversation-starter to answer questions and
educate them on how physical therapists help people.
Neva Greenwald, director of the PT program in the School of Health
Related Professions, said the event was an effort to incorporate advocacy
into academics, demonstrating the need for professional involvement
alongside practice.
“Advocacy upholds and promotes patients’ health-care rights,” Greenwald
said. “Practitioners should support community health and policy
initiatives that focus on the availability, safety and quality of care and the
promotion of healthful environments.”
Greenwald explained that because clinical practice in health care is
governed by law, practitioners must be aware of public policy and how to
contribute their expertise to questions about the improvement of health in
the community.
“The goal is to make sure the students are comfortable with being advocates
and with contacting their legislators, because often practitioners are
called upon to help legislators with health care-related issues,” she said.
And step one is getting some face-time.
After a morning of mingling and handshaking in the rotunda,
students filed into the Senate gallery to watch lawmakers in action. Before
the session was called to order, they received an official welcome by the
chamber and Lt. Gov. Phil Bryant.
“With my dad being in politics, I know that lawmakers can’t know
about every issue in every health-care field,” said Clarke, a second-year
student. “That’s why it’s important for us to be available and to reach out.
“It’s good for us because it helps us be better members of our
community.”
Students, she said, are required to join the American Physical
Therapy Association as student members, and later in the month will
have the opportunity to attend a conference in New Orleans.
February 7, 2011
Published by the Division of Public Affairs at the University of Mississippi Medical Center
Chancellor
Editor:
Photographer:
University of Mississippi:
Bruce Coleman
Jay Ferchaud
Dan Jones, M.D.
Vice Chancellor for
Staff Writers:
Patrice Sawyer guilfoyle,
Support Staff:
lynn griffin, Peggy Wagner
Health Affairs:
James E. Keeton, M.D.
Jen Hospodor, Jack Mazurak,
Janis Quinn, Matt Westerfield
To browse archives or read
the most current CenterView,
Chief Public Affairs and
Lead Designer:
visit the Public Affairs website
Communications Officer:
Tom Fortner
Derrick Dyess
http://publicaffairs.umc.edu
— CenterView is printed by the UMMC Department of Printing —
For more news and information of interest to the Medical Center family, visit Medical Center News online (http://info.umc.edu/)
The awareness seems to be catching on. At the Capitol, well-versed students
discussed current issues facing the profession, ranging from direct access to care and
patient safety to Vision 20/20.
“Vision 20/20 is a goal for physical therapy,” said Lisa Bryant, second-year PT
student. “The APTA is pushing for all physical therapists to have the Doctor of
Physical Therapy by 2020.”
Bryant said after she graduates, she might like to relocate and see how different
states handle physical therapy, although she and her husband probably won’t venture
too far from their families.
Senator Eugene “Buck” Clarke and his daughter Ellen Clarke, PT2. Matt
Eubanks, PT1; Heather greer, PT1; and Michael Brown, PT1 look on.
“And I would rather stay here to give back to the state that gave me this
education,” she added.
For many of the students, advocating for their health-care profession boils down to
forging relationships with the policymakers.
One of the people it’s good to know is Sen. Eugene “Buck” Clarke of
Hollandale — Ellen Clarke’s father — who announced the students during
session. Clarke, who serves on a number of committees, including the Public
Health and Welfare Committee, said that the deadline was approaching for bills
to come out of committee. Each year, there are a lot of interest groups anxious
to see certain bills pass and certain bills die.
He said having students at the Capitol “is a good way for UMMC to help us,
because every agency competes for those dollars.
“We have all these state agencies and all of this funding to manage, so it’s always
good to put a face with a profession. For groups of students from publicly-funded
universities to come and share what they do, it reinforces to us how important all
these programs are.”
Centerview, published every other week, is
the internal publication of the University of
Mississippi Medical Center, the state’s only
academic health sciences center. Content
features news of interest for and about Medical
Center faculty, staff and students. Content may
be reprinted with appropriate credit. Ideas for
stories are welcome and may be submitted
by e-mail to bcoleman@pubaffairs.umsmed.edu
or delivered to:
Division of Public affairs
The University of Mississippi Medical Center
2500 north State Street
Jackson, MS 39216-4505
(601) 984-1100

4
CENTERPIECE
FACE The
Taste of the U co-chair honored for providing world-class care for Mississippi’s children
of PEDIATRICS
by Patrice Sawyer Guilfoyle
D
r. Owen “Bev” Evans may have stepped down as chair of the Department
of Pediatrics this month, but he’s stepping up to lend his time and talent in
another way.
He and his wife, Lynn, will serve as honorary chairs of the 2011 Taste of the U –
the largest fundraiser of the UMMC Alliance, set for Saturday, Feb. 19.
A portion of the proceeds from the event will benefit the Batson Community
Outreach Program – a project chosen by the Evanses to educate children in the
community – and an “appearance room” at the UMMC Cancer Institute where
patients can try on wigs in a private environment. Another
portion of the proceeds also will go into
a building fund
CENTERVIEW | February 7, 2011
Emily Young, M4, Dr. Bill Hanigan, Dr. Bev Evans,
Jane Criddle, and Dr. Betsy Herrington.
with patient Peter Nunnelee of Oakland, Ms.
for a UMMC Hope House, a home-away-from-home for seriously ill outpatients
undergoing treatment at the Medical Center.
It’s the tradItIon of the UMMC Alliance, a volunteer support group for
the medical center, to recognize individuals who have dedicated themselves to the
institution, the community and the state at Taste of the U. Celeste Eason, Taste of
the U co-chair, said Evans exemplifies that type of dedication.
“As the second chair of pediatrics in the 55-year history of the Medical Center,
it was quite easy to put his name, along with his wife, Lynn, forward as
the 2011 honorary chairs,” Eason said.
For the past 27 years, Evans has served on the faculty of the
University of Mississippi Medical Center in both pediatrics and neurology.
For 22 of those years, Evans led the Department of Pediatrics
and served as medical director of the Blair E. Batson Hospital for
Children, Mississippi’s only children’s hospital.
His list of accomplishments during that time shows that he
was a man with a mission: developing new pediatric programs,
recruiting subspecialists and promoting multimillion-dollar
building projects to provide comprehensive care for children in
the state, including a surgical suite, the Eli Manning Children’s
Clinics and the current pediatric emergency department
construction.
He led all those efforts while still seeing patients in the
clinic.
Evans’ motivation was a desire to provide Mississippi’s
children with the best health care available right here at
home. He graciously acknowledges the help of countless
volunteers and donors, but he was often the face of Batson
Hospital during this critical growth period.
Borrowing from his artistic talents, Evans’ satisfaction
comes from turning a vision into a reality.
“I like to make things. To me, that was the most
fun, to seize the opportunities to grow something for
the state,” Evans said. “We don’t want our children to
have to leave the state to get their care.”
a 1973 graduate of Vanderbilt University
Medical School, Evans completed an internship at
Children’s Orthopedic Hospital and Medical Center
in Seattle. He spent two years in the
U.S. Naval Medical Corps and returned
to Vanderbilt for postgraduate training in
pediatrics and neurology.
He joined UMMC in 1983, and five
years later, he was appointed the second chair
of the Department of Pediatrics, following Dr.
Blair E. Batson, whom Evans calls a mentor and
friend.
“Dr. Batson taught me. He and I have a great
relationship,” he said.
With his appointment as chair, Evans requested
that a new fundraising organization for the hospital be
formed, Friends of Children’s Hospital. The organization
has contributed more than $6.8 million to the
hospital since its inception.
Suzan Thames, one of the first members of the Friends Board, remembers
when Evans asked her to help establish and to lead the fundraising group. She said
she had no idea how ambitious his plans were for the hospital.
“He just kept plugging and plugging and said we could do it. His whole spirit,
his whole attitude was we could do it. He made me a believer,” she said. “He set
the bar for us, and we intended to meet every aspiration.”
through communIty Involvement and coalitions, the physical
expansion of Batson Hospital began to take shape. Evans brought together the
groups who wanted to help achieve the goal of a stand-alone children’s hospital
—the Junior League of Jackson, the Ronald McDonald House, Candlelighters and
the Children’s Miracle Network.
The Junior League raised the funds to create the Mississippi Children’s Cancer
Clinic in 1991. Around that time, Evans promoted the idea that floors needed to
be added to the top of the cancer clinic. The five floors were completed in 1997
and became the Batson Hospital. Another two floors were added in 2004 for the
pediatric surgery programs.
With construction projects in the works, Evans began adding to the
department’s faculty, hiring pediatric specialists and working with community
pediatricians to build relationships. In 1989, the pediatrics department had 19
physicians; currently, 80 physicians work in the department.
“We’re very fortunate to bring back the best and the brightest to take care of
our children,” Evans said.
One of the faculty members who joined the department during the
growth was Dr. James Keeton, vice chancellor for health affairs at UMMC.
He was a pediatric urologist under Evans.
“For several years, I was Dr. Keeton’s boss,” Evans said with a smile.
Keeton said he became very close to Evans, helping him build the
pediatric surgery program and traveling with him around the state to
visit community pediatricians.
“Bev’s No. 1 accomplishment besides improving facilities, which
he did, was to increase the number of general pediatricians in the
state. He moved pediatric care up to an incredibly high level. That
is a huge legacy,” Keeton said.
evans adopted Batson’s motto of “children aren’t just
small adults.” That guiding philosophy is behind the work of
ensuring the hospital has modern, state-of-the art equipment
and facilities tailored especially for children.
Evans said his wife Lynn is his biggest supporter.
“Without her, I would not have been able to do what I did,”
he said.
A writer and frequent columnist, Lynn Evans is
a health-care activist and an outspoken advocate for
the health needs of Mississippi’s children. She said
her husband wanted the hospital to belong to the
community and serve as a source of pride in the
state. He also wanted a hospital that takes care of
all children, no matter whom they are or where
they live.
“When he has a vision, not only can he see
where he needs to go but he’s very good at
planning how to get there,” Lynn Evans said.
“When we first came here people didn’t
realize the importance of getting specialty
care for children.
Now we have a
community who
knows where
Children’s Hospital
is and wants to
support it. That was
really his vision.”
Lynn Evans said
relinquishing his duties
as chair won’t slow
Evans down. He likes to build furniture, make wooden toys for their grandson and
travel. “This is a man who is rarely still,” she said.
evans, who has been painting since he was a child, regularly donates
paintings for charity art auctions. One hundred percent of the proceeds from the
sale of these pieces benefit the charities. Evans drew the artwork featured on the
Taste of the U shirts and he donated the original painting for auction at Taste.
Creating something for others to enjoy has been Evans’ inspiration. Now, he
said, it’s someone else’s turn to lead the Department of Pediatrics into the next
phase of growth into academic and research programs.
Evans is grateful for every donor and volunteer who made Batson Hospital what
it is today. From the chicken dinners to the 5-mile walks, they all matter to him.
“When you give of your time and efforts and money, you want
to know it made a difference. What they did made
a difference,” he said.
Dr. Bev Evans and wife Lynn
You’re Invited!
The 2011 Taste of the U is scheduled from
7-10 p.m. on Saturday, Feb. 19, at the Jackson
Medical Mall Thad Cochran Center. UMMC
employees prepare their best dishes for
party-goers to sample and celebrity judges pick
winners in various categories.
This year’s judges are IHL Commissioner Hank Bounds, Chef
Luis Bruno, Hinds County BancorpSouth President Tommy Darnell,
Mayor Harvey Johnson, first-ever MasterChef winner Whitney Miller,
and Chef Chan Patterson. Items will be up for bid in a silent auction
and music will be provided by Hunter Gibson and the Gators.
UMMC Alliance will be giving away window decals, selling
Taste tickets, T-shirts and a $1 chance for on-campus parking or
free parking for a year. Alliance members will have items for sale
at tables located in the breezeway between the old and new
hospital and next to the ATMs at the entrance to McDonald’s
from 11 a.m.-1 p.m. on Feb. 11 and 18.
Taste tickets are $25 for general admission, $15 for
students and $5 for children under the age of 12.
Reserve tickets now by calling 5-1133.
February 7, 2011 | CENTERVIEW
5
CENTERPIECE

6
CENTERVIEW
ON ON the the Move...
Move...
Improved teamwork drives Information Systems to medical mall
by Bruce Coleman
A
s part of the University of Mississippi Medical Center’s long-range
transition to make more clinical operations available on its main
campus, Division of Information Systems staff have relocated to
the Jackson Medical Mall That Cochran Center.
In fact, the majority of
the DIS workforce – close
to 200 employees – moved
last weekend to what is
now a virtual “command
center” for information
systems in the northern-most
section of the medical mall behind
the UMMC Cancer Institute. Four large
and four medium-sized conference rooms
and six small meeting areas surround individual
employee cubicles in the mammoth 36,500-square-foot space that was once
the Woolco Department Store.
The move represents the completion of a career circle for one DIS employee,
whose first job in high school was as a sales clerk in the automotive
division of Woolco some 35 years ago.
“She told me her first job was in that space, and her last job will be in
that space,” said Charlie Enicks, UMMC chief information officer, with a
laugh. He said the relocation represents an opportunity
for the division to
CENTERVIEW | February 7, 2011
become more cohesive, allowing for improved internal communication and
customer service.
“We’re so spread out, we have people in buildings everywhere,” Enicks
said before the move. “We wanted to be more together, but there wasn’t that
kind of space available on campus.
“This provides really great space relatively close to campus.”
DIS personnel who have moved to the mall include the applications
group, information security, administrative functions, most of the technical
staff and all of the consulting staff. Enicks said the LINC team will relocate
to the mall from the Alumni House once that project goes live this summer.
Otherwise, the only DIS staff remaining on the main campus will be the
operators in the computer room, desktop support personnel central to the
Service Desk and IT support analysts already embedded in departments.
Staff aren’t the only Division of Information Systems
resources on the move.
This spring, the division’s primary application server will be relocated to
the new Data Center in the Mississippi State Institutions of Higher Learning
building off Lakeland Drive.
Enicks said the move was necessitated to “provide redundancy for missioncontrol
systems” and to house the new LINC and Epic technology.
Aaron Champion, is on the DIS MAC
(Move, Add, Changes) Team.
Floor plan of the new DIS offices
at the Jackson Medical Mall
“There will still be a lot of support on campus,” Enicks said.
“Our goal is to not degrade support levels during the move and then
continue to improve the way we deliver service.
“Our customers should not see a difference.”
Logistics represents the only real wrinkle to the move, but
Enicks said the Department of Physical Facilities is working with
DIS to ensure ways for employees to quickly get to campus when
needed.
“My expectation is our customer service won’t be hindered,”
he said. “Walking from one of the L Buildings on Lakeland to the
hospital takes just as long as driving from the mall.”
Enicks is no stranger to being housed away from the main cam-
Over the last few weeks, the Department of Human Resources at the
University of Mississippi Medical Center has come to resemble an old high
school buddy: You may not see him as often as you used to, but he’s always
available whenever you call.
The continued focus on customer service that has become a priority
for the department over the past year hasn’t
gone away since many of its offices relocated
to the old student housing apartments Jan. 10.
If anything, the move provides an opportunity
for Medical Center employees to become
more familiar with the electronic services HR
provides, according to Scott Stanford, director of
compensation and benefits.
“We want to make sure we are providing the
top service every employee can receive, whether
high-touch or high-tech,” said Stanford. “We’ve
made strides toward that and we’re pushing to
get better.”
The high-tech portion of that equation can be found easily on the UMMC
Intranet – where employees can access “My UMMC Employee Self-Service”
under “Hot Spots” – or on the Internet, where employees can select the “My
UMMC” icon on the top right-hand corner of umc.edu. And as always, HR
representatives are available by telephone.
pus: he said a similar relocation had taken place at an institution
where he had worked previously.
“It turned out to be a great thing, because the bulk of our group
was together,” he said. “We even had customers come to us, because
they liked the change of scenery.
“We have an eye towards having the same thing
happen here.”
Which means upheaval sometimes can be a good thing.
“It’s an exciting time for DIS,” he said. “We have been
steadily improving our services and applications. We look
forward to the improved teamwork our new digs
will afford us.”
HR departments retain customer service focus throughout relocation
“We want to make sure we are
providing the top service every
employee can receive, whether
high-touch or high-tech.”
But if an employee really wants to visit with an HR representative
one-on-one, the opportunity hasn’t gone away. It’s just been relocated
to a different space.
HR Benefits, HR Leave Processing, HR Background Verification and HR
In-processing all have found new homes in the old apartments. Other HR
services, including HR Fingerprinting (R102A) and
HR International Services (R105), have relocated to
the first floor of the Research Wing. HR Employee
Relations and the Office of the Chief Human
Resources Officer remain in their same locations.
An HR General Benefits Office is available in
R105 for employees who wish to pick up and drop
off forms related to various HR processes.
Although the bulk of the Benefits Office may be
out of sight, Stanford intends to keep it on the
forefront of UMMC employees’ minds.
“We have a lot of information and services available
online, and we’re in the process of upgrading our HR webpages,” he said.
“Employee self-service will provide enhanced access to employees online in July.
“But just because there’s a lot of high-tech options out there, employees
need to know all they have to do is pick up the phone if they have any questions
or want to be walked through anything they see online. We’re going to give the
best service we can in whatever format people want to use us.”
— Scott Stanford
February 7, 2011 | CENTERVIEW
7
CENTERVIEW

ConTInUED FroM FronT PagE Ò
After 1.7 million miles, 13,000 patients, AirCare logs perfect safety record
“It’s a brother-sister thing,” says Bo Sullivan, flight nurse.
“Or a mama-son thing,” replies Jamie Miller, newborn transport nurse.
They’ve been together on so many flights, they’ve lost count.
“We were young when we all started,” says Cathy Delaney, newborn transport
nurse. “Now all of us have to have reading glasses.”
“I used to jump off the helicopter. Now I sit on the edge and climb down,” says
Miller.
“Reading glasses have become part of your essential gear,” says flight nurse and
paramedic Todd Perry.
This foursome is part of a crew that includes 11 RNs, 12 paramedics, eight pilots
and four mechanics. One helicopter (the newest) is based here; a second, based in
Meridian, was added in 2009.
IN 15 years, the AirCare crew has flown more than 1.7 million miles and
transported more than 13,000 patients with a perfect safety record.
The two choppers are the only emergency helicopters in the state that are
instrument rated, meaning they can fly in almost any weather except dense fog,
tornadic winds and ice.
That can make flying interesting. The crew agrees you don’t have to love to fly to
do the job. You just have to do it.
Perry is an aviation enthusiast and has a fixed- wing license. The Medical Center’s
original helicopter, LifeStar, (in service from 1983 through 1990) picked up his
father when he sustained a head injury.
“I was a child, but I remember asking someone what you would have to do to
get a job on a helicopter,” he said. “I’ve always wanted to fly.”
Delaney, on the other hand, almost quit her job in newborn transport when she
got her orders to be part of the helicopter service.
“I was terrified. I was hyperventilating during the first trip to pick up a patient.”
She had been a nurse in the newborn intensive care unit and joined the ground
ambulance newborn transport team in 1993. Three years later, she was a reluctant
member of the AirCare crew.
She got over her fear. Now she says she loves every
minute of it. Wouldn’t do anything else.
“I just developed a lot of camaraderie with my
fellow crew members . . . and the pilots. My life is in
their hands, and I trust them.”
The nurses and paramedics may be the people
the patients remember most vividly, but after all, air
transport would not exist without specially trained
helicopter pilots. And they do more than just fly.
“The pilots will get dirty with you,” says Perry.
“After they land the copter at a hospital, they’re right
there with us with the patient, holding bags, handing us
gear, holding lights. They’re a wealth of help.”
sullIvaN, a lieutenant colonel in the Air
National Guard, describes his colleagues and himself
as “type A” personality types – focused, driven and
having the ability to “adapt, adjust and improvise.”
“You never know what you’ll find at the destination,”
he said. “Often it’s not what you expected at all—like
going after a baby and having to resuscitate an adult as
well.”
“We all have a little McGyver in us,” said Perry, referring to the popular
television character who evades death and catastrophe with a Swiss army knife
and duct tape.
Miller is especially adept at repairing malfunctioning machines in the air.
“We don’t fly with a mechanic, and I’m pretty good with tools.”
This high-intensity, adrenaline-pumping job isn’t for everyone, but it’s not
without its rewards.
“There’s just nothing like knowing you had something to do with saving a
person’s life,” Delaney said.
aNd the blue juMp suIts, regulation attire for the crew, are
becoming very well recognized around the state. The excitement generated
by an AirCare landing in a rural community makes the crew minor
celebrities.
“I think we’ve become pretty good ambassadors for the University,” said Perry.
The crew gets a lot of positive reinforcement from the reactions of the hospital
staff and ground crews when they arrive.
“It’s usually, ‘Thank God you’re here,’ ” Perry said.
Miller said one nurse in a rural hospital, relieved that her patient was leaving in
the hands of newborn specialists, told her, “I like your front, but I like your behind
a lot better.”
Donna Norris, chief flight nurse and director of AirCare, expects and gets the
best from her crew. She’s been with AirCare since 1997, and now she’s the department
head, rarely getting the opportunity to go up now.
“I do miss that,” she said.
Being a comfort and help to people in dire need is what drives most emergency
responders, including flight crews.
“I held a man’s hand and talked with him all the way back from south
Mississippi on one flight,” Norris said. “He had a horrific facial injury and was
terrified. When you get to help people in situations like that, there’s no higher
job satisfaction.”
The Flying Trauma Center
The new AirCare helicopter is 43 feet long, shorter than the previous one at 52 feet, but with a much roomier interior. It
easily holds one pilot, three medical personnel and two patients at one time (The normal configuration is one pilot, two
medical personnel and one patient).
“This means we can take a physician with us if necessary,” said Donna Norris, AirCare director. “There are some things nurses
and paramedics cannot do, such as insert chest tubes, so if we know we’re going to have that to do, we can take an ER doc with us.”
The new copter travels at 125 miles per hour and holds about 230 gallons of fuel. It has a carrying range of three hours,
or 450 miles. It can go from Jackson to the Gulf Coast in 55 minutes.
According to Capt. Paul Reihle, Aircare pilot, it has the most advanced aviation technology available, including full instrumentation
for flying in most visibility-reducing conditions.
“It practically flies itself,” he said.
It’s not just a fast helicopter, said flight nurse Paul Boackle.
“We bring a level of care to other parts of Mississippi that may not be available there,” he said. “We take them the
University’s ICU, the trauma center and the neonatal intensive care unit.”
Norris says part of the flying trauma center is the ability to take blood with them for transports.
“You can’t deplete a rural hospital’s supply,” she said. “In that sense, we’re taking the blood bank to the patient. Few air
emergency services can do that.”
Anniversary reception
AirCare will celebrate its 15th anniversary
with a reception on the flight deck from
1-3 p.m. on Tuesday, Feb. 15. Attendees
can enter their names for a chance to fly
with the crew around the campus and
downtown Jackson.
February 7, 2011 | CEnTErVIEW
3
CEnTErVIEW

8
CENTERVIEW
EARLY HELLP by Jack Mazurak
A recently released University of Mississippi Medical Center study of 190
pregnant women with HELLP Syndrome, a severe form of preeclampsia, further
underscores the effectiveness of a locally formulated treatment called the Mississippi
Protocol.
“What this paper shows is that by identifying mothers who are moving toward
HELLP and starting the protocol early on – starting steroids and controlling systolic
blood pressure – helps to speed the mother’s recovery. It slows and can stop the
Co-authors on a study of UMMC patients with HEllP Syndrome are, from left,
ob/gyn fellow Dr. Justin Brewer, clinical research assistant Pam Blake and Dr. Jim Martin,
professor of obstetrics and gynecology and the study’s principal investigator.
disease progression,” said Dr. Jim Martin, professor of obstetrics-gynecology and the
study’s principal investigator.
HELLP Syndrome is an acronym for the symptoms defining it – hemolysis, or the
breaking down of red blood cells, elevated liver enzymes and low blood platelet count.
While it causes few maternal deaths in developed countries, it can disrupt renal function,
cause liver hematomas or hemorrhages, strokes and cardiovascular problems.
OF the 190 wOMeN studied from 2000-07, Martin and his team saw no
maternal deaths, strokes or hemorrhages develop. Only two women suffered cardiovascular
complications.
Of 163 patients who were below class 1 status in HELLP Syndrome when doctors
began the protocol, only 39 women – 24 percent – progressed to class 1. Only
18.2 percent of class 1 and 2.4 percent of the less-acute class 2 patients subsequently
developed major maternal morbidity.
The journal “Hypertension in Pregnancy” released an online abstract of the
study in January. Print publication is expected this spring.
“This is the first study to show that using such a protocol, if initiated early enough
in the disease process, can slow down disease and minimize excess morbidity,” said
Martin, director of maternal-fetal medicine. “The protocol doesn’t change the fact that
the patient came in with HELLP. It won’t reverse it, but it will slow or stop it.”
Traditionally doctors give preeclamptic mothers corticosteroids, such as Decadron,
on the baby’s behalf. Steroids speed fetal lung development and allow an earlier
delivery. Once delivered, preeclampsia usually subsides.
CEnTErVIEW | February 7, 2011
Martin and his team developed the Mississippi Protocol throughout the
1990s. When they realized the effect of steroids on the mother – slowing and
sometimes stopping the advance of HELLP – they made it a key aspect of their
protocol.
the MIssIssIppI prOtOCOl is still considered experimental, not the
standard of care but certainly within it, Martin said.
“Not everybody in the profession uses it because there’s been no large, randomized
controlled study that proves it effective,” he said. “Still,
we’ve been down this treatment road so long now, with such
good results, I wouldn’t want to expose those moms to anything
but.”
The National Heart, Lung and Blood Institute decided
against funding such a study that Martin and his team proposed
in the late 1990s.
“A large randomized study would be a tremendous undertaking
and quite expensive,” Martin said. “We had 26 centers
across the country involved and an independent data-monitoring
center and a proposed 1,500 patients.”
The somewhat rare nature of HELLP and that it’s often misdiagnosed
further complicates prospects for a nationwide study.
UMMC sees 30-45 HELLP patients annually, more than average
for hospitals because Mississippi’s population is the nation’s
unhealthiest. And with UMMC’s expertise in preeclampsia and
its standing as the state’s only academic health science center,
many preeclamptic mothers get referred to the Medical Center
from elsewhere in the state.
the COMpleted study of 190 women was funded by
Department of Obstetrics and Gynecology revenue. Co-authors
include Dr. Michelle Owens, Dr. Sharon Keiser, Dr. Marc
Parrish, Dr. Kiran Tam Tam and Dr. Justin Brewer. Co-authors
Julie Cushman and Pam Blake, clinical research coordinator,
along with Warren May, professor in the Center of Biostatistics and Bioinformatics,
assisted with gathering and managing the study’s data.
The next step, Martin said, and one which Owens is already working on, is
figuring out just why the steroids work for the mothers.
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Study indicates Mississippi Protocol
effective in treating preeclamptic women
Dr. James Martin and his team developed the Mississippi Protocol, a
treatment course for HELLP Syndrome, throughout the 1990s. Its
precepts are:
Early identification of preeclamptic women who may be developing
HELLP Syndrome;
Administer corticosteroids quickly if there’s epigastric pain, eclampsia
or rapid HELLP progression;
If not, monitor platelet counts and lactic dehydrogenase (LDH) and
aspartate aminotransferase (AST) levels;
Monitor systolic blood pressure, treat with antihypertensive drugs
if above 160; and
Administer corticosteroids with decreases in platelet count
and LDH or increases in AST.