Natividad wins Trauma II designation
- January 6, 2015
By Roberto M. Robledo | The Salinas Californian
Salinas, CA – January 6, 2015 – The flow of trauma patients — and trauma-related revenues — usually sent north in an emergency was officially re-routed back into Monterey County on Monday.
A host of officials from the county and Natividad Medical Center held a news conference to announce the designation of the hospital as a Level II Trauma Center.
Before a crowd of about 200 people, speaker after speaker hailed the "momentous occasion," the plan and process and the community commitment made in establishing a trauma center closer to home. Among the dignitaries were retiring county Supervisor Lou Calcagno, Natividad board president Fernando Elizondo and agribusinessman John D’Arrigo.
The center began taking patients in October — more than 200 to date — but has awaited final designation from the Monterey County Emergency Medical Services Agency.
A trauma center comprises specialized surgeons, staff and equipment to treat the most severe and critical injuries.
"The designation of the trauma center … will benefit trauma patients and their family members and improve the overall quality of health care in our community," said Kelly O’Keefe, Natividad’s interim CEO.
Natividad is designated to serve Monterey County but other hospitals can send patients to NMC if they choose, said Chelsi Mattler, trauma program manager.
Before now, local trauma patients were flown to San Jose-area hospitals for treatment. This system burned precious time out of the "golden hour" — what emergency doctors refer to as the time immediately after an injury occurs. After that first hour, a patient’s survival rate plummets during the 20-minute flight to reach a trauma center in the Santa Clara Valley.
"How much time will it take to call up a helicopter, have it pre-flighted at the airport, fueled, a team to assemble at the helicopter, for them to fly to our hospital, come in to the hospital, package the patient, take him back out, put him in the helicopter, then fly him to San Jose," asked Dr. Craig Walls, Natividad’s emergency medical director.
"Compare that with, you come in … get you on a gurney and then a trauma surgeon opens your chest. The time savings is massive," Walls said.
Having worked in some of the best in the world, Walls knows trauma centers. He said of Natividad’s: "We have everything we need here."
"The trauma center is not a thing or a place. What makes it a trauma center is that we have board certified trauma critical care surgeons waiting for patients, 24/7, 365 days a year. That’s the guy or the gal who, as the patient hits the bed, can perform surgery immediately. They can open your chest, spread your ribs, reach in and suture a hole in your heart, clamp the aorta, decompress the brain. There’s a lot of things emergency docs can do but we can’t take that extra step that trauma surgeons can, to put our hands on internal bleeding and literally save someone’s life with your fingers."
Surgical services staff applauds at a ceremony on Monday marking Natividad Medical Center’s designation as a Level II Trauma Center for Monterey County.(Photo: Jay Dunn/The Salinas Californian)
To help them in their work, trauma center staff has 51 pieces of new equipment. Walls is most impressed with three:
• Sonosite portable ultrasound machine. "It can instantly look inside your abdoman and chest to see if there’s bleeding. It allows us to do a ‘fast exam.’ In a few seconds, I can look in both sides of your abdoman, around your heart … and tell the trauma surgeon whether you’re bleeding and need to go immediately into the operating room."
• C-MAC fiber-optic laryngoscope, "I can slip it in the back of your throat and have a high definition view of your airway which allows me to put a breathing tube into a damaged, bloody, obstructed passage." Can be used with tiny babies to 500-lb. patients with thick necks. It eliminates the need for tracheotomy. "If I can do a direct larengoctomy with a visual aide from that machine, I can get a breathing tube into your mouth. No need to cut open your neck."
• Camino monitor. "A small monitor that allows us to drill a hole in the head of a brain injured patient and insert — basically, a pressure monitor. It displays on the monitor how much pressure is in the head to determine surgery or decompression. Without that piece of equipment, you don’t know the pressure in the head and if it’s critical."
"We can expect thousands of patients to benefit from just these three pieces of the 51 pieces of equipment" purchased for the trauma center, Walls said.
D’Arrigo of D’Arrigo Bros. Co., said the trauma center represents the kind of health care services his organization is helping Natividad provide for farmworkers and their families.
As a founder of The Agriculture Leadership Council, he’s seen to it that the county’s safety-net hospital has the money it needs to equip the trauma center with the best medical equipment available. TALC has provided Natividad with more than $1.3 million toward that end, he said.
No figure was available Monday as to the start-up costs of the trauma center.
However, Ray Bullick, county health public administrator, called the trauma center an added benefit for county residents and those who travel through the area. He said the county now will benefit economically from the more than 300 trauma cases annually that have been flown out. He estimated that as much as $15 million in trauma treatment and services will now remain.
The toll on families with a loved one in a trama case should also be lessened with a local trauma center.
"Before the trauma center, families had to be separated during critical, stressful times," said Debbie Nevarez of the local chapter of the SEIU.
No longer will they be separated by time and distance in such emergencies, she said. "No longer will they be faced with a $30,000 bill for a helicopter ride they can’t afford."
Peace of mind may be yet another benefit for having a trauma center closer to home.
"To have a team of trauma surgeons – there’s always one of them here – It’s not just me and my ER folks," said Dr. Walls. "It’s someone with that level of training and expertise that you would want your family to have standing by, just in case, god forbid they ever need it."
Follow Roberto M. Robledo on Twitter @robledo_salnews #salinas.
At a glance
• Each year, trauma accounts for 41 million emergency department visits and 2.3 million hospital admissions nationwide
• Trauma is the leading cause of disability
• Trauma is a disease. It is mostly preventable and associated with high-risk behavior.
• Trauma is the leading cause of death in people ages 1 to 45
• It accounts for 45,000 to 50,000 deaths annually
• The economic burden of trauma is about $406 billion a year, including healthcare costs and lost productivity