Trauma system developed for quicker care

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.