Saturday, January 20, 2018
Opinion

Column: Improving access to trauma care

The terrible bombings in Boston and the explosion near Waco, Texas, which combined have cost at least 15 lives and injured nearly 400 people, are tragic reminders that the potential for danger is all around us. And, unfortunately, no one is beyond the reach of harm.

These incidents teach us that we must remain vigilant. This is true of our armed forces, our intelligence communities and our emergency response systems, including trauma care at our nation's hospitals. It also teaches us that every community must be prepared for any possibility.

This all-hazards preparedness ensures that first responders and medical professionals have the best equipment and ability to respond to the worst challenges conceivable, including emerging infectious diseases, mass causality accidents, or even terrorist events.

Thankfully, many lives in Boston and Texas were saved because they had immediate access to trauma care.

Not all Americans are so lucky. Fortunately, the Florida Legislature has an opportunity to improve access to trauma care.

As a combat medic in Vietnam and a trauma surgeon in California and then Arizona, I saw the worst injuries imaginable: gunshot wounds, mangled limbs and traumatic brain injuries. And because we had the training and equipment in our trauma care units, we could stabilize these patients and get them off to surgery for added care. It's a tough job, and credit goes to the thousands of first responders, trauma doctors, assistants and nurses who fight to save patients every day.

In the aftermath of 9/11, the federal government invested billions of dollars in our nation's rapid response systems and to equip hospitals from coast to coast with advanced technologies to help patients in need of trauma care. Specially equipped trauma centers ensure that patients have access to the care they need when the most horrific incidents occur.

But trauma injuries aren't isolated to mass casualty events like what happened in Boston or 9/11. Traumatic injuries happen every day in car crashes, bad falls and workplace accidents. Because proper treatment of trauma injuries is essential to survival, patients need access to a trauma center, beyond what a typical emergency room or hospital is able to provide. Studies show that a trauma patient's survival chances increase by 25 percent when treatment is provided in a timely fashion at a trauma care center.

The American College of Surgeons has established guidelines in their Resources for Optimal Care of the Injured Patient that outline the elements and expertise needed to care for trauma patients. These guidelines provide caregivers and state oversight organizations with information necessary to effectively treat traumatic injuries. And communities can be confident that if the ACS verifies a trauma center, it meets the high standards set by this pre-eminent organization.

Unfortunately, many Americans live hours away from their nearest trauma center — and when seconds matter, lost minutes traveling to find care can mean the difference between life and death. Consequently, federal and state governments need to work together to strengthen our public health infrastructure so that more Americans have access to the trauma care they need, when they need it.

Not only are trauma centers important in times of need to receive patients, but in many communities they are also centers for learning. Local fire, EMS and other medical professionals rely on the training and continuing education courses that trauma centers host. This education empowers first responders with the skills they need to more effectively respond to immediate traumatic events in cities and towns throughout the nation.

Right now, the Florida Legislature has a chance to make it easier for a hospital to become a Level II trauma center by allowing hospitals to follow the ACS trauma guidelines and procedures for certification. This streamlining effort would reduce unnecessary and costly bureaucratic processes that hamper local hospitals' ability to care for the needs of their community. After being verified by ACS, trauma facilities must remain in compliance with all federal, state and local laws. Naturally, if facility were to fail to maintain compliance, the Florida Department of Health could rescind its Level II certification.

This commonsense approach to improving access to care is already being done in about half of the states around the country — helping to put patient care and access at the forefront of trauma care. If Florida moves to simplify the certification process for trauma centers, this will help provide better care to patients across the state.

And while we may not be able to save every life, we will certainly be able to save many more.

Richard Carmona was the 17th surgeon general of the United States and is a fellow of the American College of Surgeons. He wrote this exclusively for the Tampa Bay Times.

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