Trauma Center Access Prevents Unnecessary Deaths

By Briana Vannozzi

Trauma related injuries are a leading preventable killer in the U.S. and where you live may play a large role in determining whether you survive. A new report from the National Academies of Sciences, Engineering and Medicine finds up to one in five people may be dying unnecessarily from car crashes, gunshots and other traumatic injuries.

The report calls for better pre-hospital intervention and finds large sections of the country don’t have quick access to Level I trauma centers. It’s urging the White House to create a system to oversee trauma care using our knowledge from military battlefields.

“Not combining into one system, but merging, if you will, that military system that’s been developed in the current war in Afghanistan and Iraq and the existing civilian systems kind of putting them together,” said Dr. John B. Holcomb, professor of surgery at the UT Health Science Center at Houston.

Dr. Holcomb is one of the study’s authors. He spent 23 years serving in the military. He points out that in the case of the Orlando mass shooting, Pulse Night Club was just blocks to a major trauma hospital. And there’s no doubt that saved lives.

“These events are increasing in frequency across the U.S. I personally see — and I think more people feel this way — not going to decrease any time soon so we need to be prepared and number one, react appropriately. And the when they do happen, to treat patients appropriately. And that’s not just medical people, it’s the immediate responder or immediate bystanders, civilians need to have some level of medical training,” he said.

Trauma is the leading killer for Americans under the age of 45. It caused nearly 150,000 deaths in 2014 alone. And cost the nation upwards of $670 billion in medical and lost productivity costs due to disabilities.

“In certain parts of the country I think it’s true. I think in New Jersey we’re fortunate we have about 10 overall Level I and Level II trauma centers. They are well distributed based on population and geography,” said Dr. Rajan Gupta, trauma medical director at Robert Wood Johnson University Hospital.

Dr. Gupta says nearly 100 percent of New Jersey’s population is within the so-called golden hour — or 60 minutes by land or air — to a top trauma center.

“What we don’t know is how many injured patients are cared for at hospitals that are not trauma centers. We don’t have epidemiological data on that quite yet. When they go to hospitals that aren’t trauma centers and are ultimately transferred to a trauma center, that results in delays of care,” Dr. Gupta said.

In New Jersey there are three Level I centers — University Hospital in Newark, Robert Wood Johnson in New Brunswick and Cooper Hospital in Camden for the south. Add in the Level II centers and Dr. Gupta says we’re well covered. But there are still swaths of South Jersey that teeter on that golden hour guideline. The national study shows about two-thirds of Americans have access to a Level I facility. But only one in four rural residents are that close.

The report underscores an important topic for trauma experts. The biggest opportunity to save lives happens well before a patient reaches a doctor.