Tuesday, May 29, 2012
Statewide Trauma System Developing in Arkansas
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LITTLE ROCK - Fifty Arkansas hospitals have been reviewed by the Trauma Advisory Council and been designated at their appropriate level for responding to emergencies.
Five hospitals are Level I, four are Level II, 16 are Level III and 25 are Level IV. The Trauma Council has completed or scheduled site surveys for several other hospitals that have not received a designation.
The Level I hospitals are equipped to provide total care and rehabilitation to an injured patient, and is staffed to operate prevention programs. A Level III hospital can assess, resuscitate and provide emergency surgery while arranging for transfer to a Level I or Level II, where more definitive surgical care is available.
A Level II hospital provides screening and definitive surgical care of traumatically injured patients, regardless of the severity of the injury, but does not have an outreach program for prevention or a general surgery residency program.
A Level IV hospital can screen and provide some care for injured patients, and is equipped to stabilize and transfer severely injured patients from remote areas where no alternative care is available to a hospital that can provide more definitive surgical care.
The legislature established a statewide trauma system when it approved Act 393 of 2009. The state Health Department is charged with implementing the trauma system.
The goal of Act 393 is to save lives by making sure trauma victims are taken to the closest facility that is equipped to respond to their particular injury. The closest facility may be well equipped and staffed to respond to a snakebite, but unable to provide the best care for more severe traumas, such as extensive burns.
In some instances it's better for the emergency responders to pass by one hospital and continue on to a facility that is better equipped to treat the victim.
The Trauma Council has gathered input from experts on brain injuries and spinal cord injuries. However, it hasn't always been a smooth process - some hospitals complained that the procedure of getting designated is too cumbersome. Physicians have disagreed on the criteria the Council should use to designate hospitals as Level I, II, III or IV. In spite of the differences of opinion, the Council has made steady progress.
The Health Department, working the with Department of Information Services, chose a company that provided 600 radios last year. Installation in hospitals, fire trucks, ambulances and helicopters is expected to be complete this year.
Before 2009 Arkansas was one of only three states without a statewide trauma system. Physicians report that injury is the leading cause of death for Arkansans between the ages of one and 44. Our fatality rate from injury is 30 percent higher than the national average and 70 percent higher for motor vehicle accidents, largely because of our extensive rural road network.
Hospitals receive grant money for equipment and staff, depending on their designated trauma level. Funding comes from a state tax on tobacco products.
Also, at least 118 Emergency Medical Services (EMS) providers had joined the trauma system, as has the Arkansas Ambulance Association. They are eligible for grants for training and other expenses incurred in upgrading to their appropriate trauma level.
One critical area is the development of electronic transfer of CT scans, X-rays and MRIs, so that the appropriate medical personnel are standing by when a trauma victim arrives.