LITTLE ROCK — Arkansas is still in the early phases of developing its statewide trauma system, but national emergency officials said Monday that it will soon be an important piece of larger efforts to coordinate emergency medical services nationwide.
Right now, emergency care is a patchwork of trauma systems and centers in different states, said Dr. Richard Hunt, director of the federal Centers for Disease Control and Prevention's division of injury response.
As a result, nearly 45 million Americans don't have timely access to the two highest levels of trauma center hospitals capable of treating the most complex injuries, he said. Having that access within one hour can mean the difference between life and death after a car accident, gunshot wound or other traumatic injury.
"If you are severely injured, getting care at a Level I trauma center lowers your risk of death by 25 percent," Hunt said.
Hunt and about 300 top emergency response officials from each state are in Little Rock this week for the National Association of State Emergency Medical Services Officials' annual conference. Association President Steven Blessing said the conference is a chance for officials to meet, collaborate, learn about the latest technology and exchange ideas.
Gov. Mike Beebe signed Arkansas' trauma system into law March 13. It's paid for with an increase in state cigarette and tobacco taxes, but the lagging economy has cut into projected firstyear funding, said Charles McGrew, chief operating officer of the Arkansas Health Department.
The system had an initial budget of $20 million for the first year, plus a $5 million one-time payment to put defibrillators in public schools and provide a radio communication system for emergency medical services statewide.
But budget shortfalls mean the Health Department is getting only about $960,000 of the $5 million one-time payment.
State officials are looking for other ways to make up the lost funding, said David Taylor, the department's section chief for EMS and trauma systems.
"We're trying to find some funding," he said. "We're looking at other avenues."
A trauma system such as Arkansas' aims to coordinate medical services statewide so emergency responderscan get patients quickly to the nearest facility that's best able to treat their particular injuries, Hunt said.
For example, a patient with a head injury is taken to a hospital with a neurologist, and someone with severe burns is taken to a burn center.
Without a trauma system, there's no network to ensure that happens, meaning a patient is often taken to the nearest hospital, even if that facility doesn't have specialists capable of treating that patient's injuries.
It's important that everyone work together - including police, fire officials, paramedics, emergency medical services, hospitals and rehabilitation centers - Blessing said. The ultimate goal is to treat the patient.
"You want them to do that without political interests and geopolitical boundaries," he said.
His home state of Delaware has had a trauma system for 10 years, Blessing said. In that time, the death rate of patients with the most severe injuries has dropped from 42 percent to 20 percent.
The association is sponsoring a new initiative to improve trauma care nationwide by making sure emergency medical services professionals throughout the country are taught and accredited under a common set of standards, said Dan Manz, Vermont's director of emergency medical services.
"EMS is really a system of care, and it has national, state and local components," Manz said.
In January, the CDC released new guidelines on how emergency responders on the scene should determine the severity of a person's injuries and what facility he should be taken to. Many factors go into making such decisions,and it's important that people work according to a common set of rules, Manz said.
Trauma centers are just one piece of a trauma system. In Arkansas, 71 hospitals have applied to become trauma centers. Ninety-one hospitals are eligible to join the system.
Each will be designated as Level I, II, III or IV trauma centers, and Arkansas' standards for each are based on national standards from the American College of Surgeons.
The most recent applications are from three hospitals in Northwest Arkansas: Washington Regional Medical Center in Fayetteville, and Northwest Health System hospitals in Springdale and Bentonville.All three have applied to become Level III centers, said Ed Barham, Health Department spokesman.
The CDC has developed a mapping tool that shows access to trauma centers in a particular area. It is available online at www.cdc.gov/TraumaCare.
Northwest Arkansas, Pages 7, 9 on 09/22/2009