LITTLE ROCK — When a new centralized communication system becomes active statewide, first responders will in some cases drive trauma patients past one or two hospitals to get them to the facility best equipped to treat their injuries.
The system, expected to be ready in some places Jan. 1, will replace the current practice of rushing injured patients to the nearest facility. The new system will coordinate statewide to determine where a patient is taken and treated based on the severity of his injuries.
The communications center - which was discussed by a committee planning the system last week - is part of Arkansas’ developing trauma system. The goal is to reduce injuryrelated deaths in the state by shortening response times and improving patient care.
“There must be some extreme culture changes in place to make this happen,” said Dr. Todd Maxson, a consultant for the Arkansas Department of Health and trauma director at Arkansas Children’s Hospital.
The trauma system is a network that will connect hospitals, ambulance services and other emergency responders statewide. It is designed to get injured people as quickly as possible to the facility best able to treat them. The communication system, or call center, is one of its key components.
Metropolitan Emergency Medical Services, a central Arkansas emergency medical services provider, will organize the trauma system’s call center under a $906,000 contract renewable for up to six years, said Ann Wright, a spokesman for the state Health Department.
The center will have six call stations with operators who will communicate with paramedics and first responders, directing patients to hospitals on the basis of the severity of injury, hospital status and local protocols, MEMS Director Jon Swanson said last week when he updated the Governor’s Trauma Advisory Council on the communications center’s progress.
Members of the public will call 911 as they always have.
After a medical technician arrives at the scene and assesses a patient, he will rate the severity of injuries and call the central command center to determine where to transport the patient.
Patients with airway problems or uncontrolled bleeding will be transported to the nearest hospital, regardless of status, Swanson said.
For all other patients, the central communications staff will call the hospital, allowing the hospital staff to prepare a treatment plan for a patient ahead of his arrival, he said.
Participating hospitals will be required to update their status on a chart that shows their capabilities in various treatments, such as imaging and treating burns. The color-coded system will allow facilities to note if doctors are on staff, if emergency rooms are at capacity and if equipment is functioning to aid in transport decisions, Swanson said.
“It may inform a decision, everything else being equal between hospital A and hospital B,” he said.
Maxson said some hospitals and emergency personnel won’t begin using the communications center for months after its January start date as they train to use the trauma system and obtain necessary equipment, Maxson said.
The trauma system will require hospitals to collaborate carefully and update the communication system with changes in status and capabilities to ensure patients are treated within “the golden hour,” he said. Trauma experts say patients are more likely to be returned to theirpre-injury state when treated within 60 minutes of the injury.
Paul Halverson, director of the Health Department, has said Arkansas’ injury-related mortality rate is 50 percent higher than the U.S. average. Organizers expect the trauma system to reduce injury-related deaths by 25 percent.
The system, funded by an increase in tobacco taxes that was signed into law in 2009, allows 86 eligible Arkansas hospitals to apply for certification in one of four levels-of-care designations, with Level I being the most extensive and Level IV being the least demanding on a hospital’s resources.
Level I and II trauma centers, for example, must have surgeons from a variety of disciplines working around the clock.
The first three trauma centers received designations in September.
The University of Arkansas for Medical Sciences in Little Rock and the Regional Medical Center at Memphis were designated Level I centers, and Jefferson Regional Medical Center in Pine Bluff was granted a Level II designation.
More than 70 hospitals will be added to the system as it becomes operational over the next two years, Halverson said.
Northwest Arkansas, Pages 7 on 10/25/2010