Wednesday, Aug 7, 2013
Statewide Trauma System is Taking Shape
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LITTLE ROCK - Arkansas now has 22 hospitals certified as Level III trauma centers, after the recent approval by Health Department officials of the application of a medical center in northwest Arkansas.
There are five Level I trauma centers serving Arkansas residents, although two are in Memphis and one is in Springfield, Missouri. There are also five Level II trauma centers and all of them are in Arkansas.
Both Level I and Level II trauma hospitals have surgical specialists available 24 hours a day, as well as medical equipment for treating patients who have suffered a traumatic injury. One difference is that Level I trauma centers have ongoing research, prevention and community education programs.
A Level II trauma center does not have a full range of specialists available at all times, but does have resources for emergency resuscitation, emergency surgery and intensive care.
Arkansas has 39 Level IV trauma centers. They provide advanced life support for trauma patients in remote areas. They have personnel who can evaluate, stabilize and diagnose trauma patients who will be transferred to medical facilities that can provide higher levels of care. In Level IV trauma centers a physician is available when the patient arrives at the emergency room.
The legislature created the statewide trauma system in the 2009 regular session with approval of Act 393. The Health Department is charged with putting the system into place. That entails awarding grants to hospitals for equipment purchases and contracting with a communications system that connects ambulances and first providers with local hospitals and clinics.
Arkansas has more than 200 licensed ambulance companies and almost 6,000 paramedics and emergency medical technicians. The trauma system pays for training so that they can improve their preparation and care of trauma patients before they arrive at the hospital.
When discussing trauma care, health experts often refer to the "Golden Hour," which is the first 60 minutes following a severe injury. Those minutes are critical for saving lives and preventing permanent disabilities.
Arkansas was one of the last three states in the nation to implement a statewide trauma system. In 2008 the American College of Emergency Physicians ranked Arkansas as the worst in the nation for emergency care.
Injury is the number one killer of Arkansans between the ages of one and 44. In 2010 our death rate from all types of injury was 31 percent higher than the national average and the death rate for motor vehicle accidents was 82 percent higher.
Funding of the statewide trauma system comes from Act 180 of 2009, which increased the tax on cigarettes and other tobacco products.
Public health officials say that the experience of other states indicates that it will take from seven to 10 years to see a measurable decline in mortality rates that can be directly attributed to the new trauma system. An essential component of our trauma system is a data registry that keeps track of patient injuries, types of care provided and outcomes.
The Arkansas registry began in July of 2010 and since then 73 hospitals have entered more than 25,000 records into the trauma system's computers. Each record has details of a trauma injury and the treatment the patient received.
Arkansas has 1,137 rehabilitation beds and 15 percent are designated for trauma patients.