47° SUNNY, Trauma system developed for quicker care
Last Modified: Sunday, November 11, 2007 at 11:00 p.m.
Oct. 20 - a Saturday - came and went with little fanfare for most. But for Melissa Fountain, it was a grim reminder of the day one year ago that she lost her husband, Bruce, to a backhoe accident on White's Lake.
It's a death she said might have been avoided had the trauma system that treated his injuries worked better.
"I've not gotten to the point where I have a peace about it," she said. "I'm still angry. I wonder why this had to happen. I know it doesn't help, but I still wonder."
State officials announced last week the development of a statewide trauma system that is designed to get trauma patients to a health-care facility best suited to treat their needs. The goal is to get them there in four minutes or less.
State Health Officer Don Williamson said trauma is the leading cause of death for Americans younger than 45, and more than 80 percent of Alabama's trauma cases are caused by motor vehicle accidents.
Alabama has the fourth highest per capita highway trauma death rate in the country.
"Even though 90 percent of all injuries are minor and can be treated at the local hospital, the remaining 10 percent who have life-threatening injuries require quick, specialized care in a trauma center," Williamson said. "In Birmingham, where there is a trauma system, there were 12 percent fewer deaths from trauma than in the rest of the state over a nine-year period."
The system, which Williamson said he expected to be fully operational throughout the state by May 2009, will serve to coordinate emergency medical technicians, a trauma communications system, hospital emergency department staff, trauma surgeons and other physicians.
The University of Alabama at Birmingham provides the only Level I trauma center in the state. Eliza Coffee Memorial Hospital, in Florence, and Helen Keller Hospital, in Sheffield, are designated as Level II trauma centers. Level II centers do not have as many resources to treat injuries as the Level I centers.
Already, the northwest region of the state has used some of the technology available to operate the system, serving as the beta site for the rest of Alabama, said Dr. Bill Vermillion, director of the emergency department at ECM.
"We know that the computers have been ordered, and the software is being worked on," he said. "Hopefully, that will get us up and running within the 18-month goal to have all the participating hospitals online."
Hospitals do have a choice to participate, Vermillion said, "and the emergency medical providers are aware of the hospitals that aren't participating, and they will be bypassed."
Dr. Amorette Miller, director of emergency room services at Keller, said consumers aren't likely to notice a change once the system is in place.
"The system is starting at the triage point and literally laying the groundwork for treatment in the emergency department," she said. "It's so crucial that an identification (of the trauma) be made at the scene."
Emergency workers talk about a window of opportunity for treatment of 60 minutes - a time physicians call the golden hour.
Fountain's husband lost much of that time in transport to a local hospital and waiting to be stabilized for transport to Huntsville Hospital, where he later died.
"I wish (the trauma system) had been in place for Bruce," she said. "I don't know for sure that it would have helped, but I always will have that in the back of my mind. Could he have lived if he had been seen sooner?"
Only recently has technology come to the point that will allow for instantaneous communication among emergency medical technicians in the field, the trauma center control system and local hospitals. Miller said back-ups are in place to prevent human error getting in the way of giving the appropriate treatment.
"We're all ready for this to be up and running, even though there will be kinks to work out," she said.
In addition to linking all of the state's hospitals through the system, it will work to link hospitals across the Southeast, said state Sen. Parker Griffith, D-Huntsville, the physician turned politician who helped get the legislation for the system passed.
"State lines are artificial boundaries in a trauma situation," he said, adding that Vanderbilt Hospital in Nashville, Tenn., could see patients from Alabama and, conversely, local hospitals could see patients from Savannah, Tenn.
Michelle Eubanks can be reached at 740-5745 or michelle.eubanks@timesdaily.com.
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Comments
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November 14, 2007 10:26:26 am
RE: http://timesdaily.com/apps/pbcs.dll/article?AID=/20071112/NEWS/711120329/1011
Unless somethings have changed ECM still lacks so much in their ER.
I lost my best friend a few months ago just because the ER doc that was there had an operation to do the next morning,at Keller and he didn't come back to ECM to sign off to have him flown to another hospital that had the Dr's that could have done what was needed.(it was a spinal cord injury).
I have been ticked off at Dr.#@$% ever since. And I saw how the pro. football player that had a much worse spinal injury was able to WALK out of the hospital after bone chips were removed from his broken spine, just made it worse.
I know I'm rambling on but it all comes down to the Dr. on duty that night. If he had just signed off to be moved ASAP to a hospital that has the specialist to treat his injurys,he may be alive today.
Instead, the doctor was more concerned about the thousands he would make on an elective procedure than a life that perhaps could be saved in another hospital.But he wouldn't be able to line his pockets if my friend had been moved.
Sorry for the long post but I needed to vent.
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November 14, 2007 11:20:01 am
It's been the same way at ECM for as long as I can remember. How many times do you hear of staph infections that start there? BUT, I think almost everyone working there wants to do a better job. They are also caught in "the machine" I'm really sorry about your friend. Sometimes life is unfair.
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November 14, 2007 11:22:19 am
themax, i am truly sorry that you had this experience, and lost your friend..i worked in that ER for many years, till i retired recently..maybe i can offer some explanation that will be of comfort to you..
sounds like the Dr you refer to, was the neurosurgeon on call..i know much about most of the Dr's who work thru there, and many would not be chosen by myself..but, your friend's nurses would have alerted the ER Dr, and he would have called for that signature (and called in another neurosurgeon, if unable to reach that one for some reason), if the patient was able to transport..
the fact that the neurosurgeon had left, tells me specialized surgery was needed, that could not be done locally..(most of the very specialty qualified surgeons, only work thru large trauma centers in the metropolitan areas)..if so, not moving immediately usually hinges on the patient's condition being too critical for transport, at that time..and often, the critical patient does not survive, 'waiting' to be moved where he needed to go for the best care (tho the ER staff is working feverishly, using procedures to hopefully upgrade his condition, so he can move)..no ambulance or chopper would move an unstable patient, to do so would bring almost certain death for such a patient..and spinal cord injuries can have some of the most critical challenges presented..
please don't think i am defending the Dr, or even the ER, i am NOT..but family and friends have no way of knowing all the criteria that HAS to be met, to assure the patient has the best fighting chance to even make it to the qualified center..
i believe everything medically known, was surely done to help your friend survive..sometimes, all the medical knowledge in the world, just won't save them....and i KNOW the staff grieves over every loss, they are deeply affected when they 'fail' a patient, regardless of the circumstances..
i do hope that maybe, this gives you some insight into the 'behind-the-scenes' of horrible tragedy, and you find a measure of peace..you and his family, are in my prayers..
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November 14, 2007 11:58:55 am
Staph and MRSA are everywhere....not just in the hospital. You come into contact with it EVERYWHERE, EVERYDAY. A shopping cart is one of the worst places to get it. Everyone thinks that staph is running rampant in the hospital. It's not!! It is running rampant in the community.
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November 14, 2007 11:59:36 am
You could not pay me to be sick at ECM.
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November 14, 2007 3:12:58 pm
You could not pay me to be sick at ECM.[/QUOTE]
I think you got it backwards, you pay them to be sick
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November 14, 2007 7:02:31 pm
I am very sorry to hear about your friend. However, your information is a bit incorrect. There are not any Emergency Doctors that are employed at ECM who are neurosurgeons. A Neurosurgeon is the type of MD who would have been the one to operate on your friend's spinal cord. The Shoals area does not have Neurosurgery coverage 24/7 365 days a year. This results in patients being transfered, when approprate to a level 1 trauma center. Some patients with spinal cord injuries do recover and some don't....God is the one who decides that. Not a MD.
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November 14, 2007 10:53:41 pm
I believe Huntsville is still a Level II Trauma Center, but they do have an excellent NICU with superior surgeons. I have been aware of plans to update the trauma protocol for some time, but a recent article states the new system will strive to place the patient in the correct setting within 4 minutes. I assume it is referring to triage and placement selection? I don't see how actual placement could be possible in less than 15.
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November 14, 2007 11:39:50 pm
oops, just realized i didn't have 'neuro' on my 'surgeon'..thanks!...............
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November 18, 2007 10:10:15 am
I am so very sorry about your friend. That has to be very painful for you, especially since he "fell between the cracks" inside the ER.
But personally, I have never had a bad experience there, but I have heard of many, and also many at our other local hospitals. NONE of them are better than the other.
I pray that you find peace about your friend.
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