HJAR Nov/Dec 2019

HEALTHCARE JOURNAL OF ARKANSAS I  NOV / DEC 2019 33 Nathaniel Smith, MD, MPH Director and State Health Officer Arkansas Department of Health had to wait for treatment, especially if the hospital needed to transfer them elsewhere for more advanced care. Delays in finding a receiving hospital to transfer a patient meant physicians were sometimes forced to take care of severe injuries that they or the hospital may not have the capacity to care for. Today, the state’s health care providers and first responders know each hospital’s capability through a four-tier hospital system, with level one being the most comprehensive. Level four hospitals are the smaller, more rural hospitals that typically see the most trauma patients. This system has a standard of best practices in place that takes each level’s capability into account. Alerted beforehand about incoming patients and their injuries, physicians at a level one hospital have 15 minutes from a patient’s arrival to be at the patient’s bedside, while level two hospital physicians have 30 minutes. Arkansas Trauma System is unique. It is the only one in the nation to include a trauma call center. This call center, known as theArkansas Trauma Call Center (ATCC), is the central point of contact. This system has the capability of knowing in real-time what the capabilities and capacity of all hospitals are within the system, so that a trauma patient can be transported to the nearest, most appropriate facility. When responding to an accident, emergency medical service (EMS) providers call the ATCC each time they have a moderate or major trauma patient to ask where they should take the patient. Hospitals also contact the ATCC for transports. In each instance, staff at the receiving hospital are notified about the patients and their injuries so they can prepare. By using the ATCC, health care providers and first responders receive the most up-to-date information to better respond to patients’ needs. For example, hospital Amay be a good hospital that is equipped to handle a patient’s needs, but what the EMS provider does not know is that the hospital just received four patients, and the operating rooms are full. TheATCC provides this information to aid in transports, as well as inter-facility transfers, as the status of all facilities are known at that time. In addition to ATCC, the trauma system created an Arkansas Trauma Image Repository that allows hospitals to upload a patient’s radiologic images, such as x-rays, to a central repository to keep patients from repeating the same procedures if transferred to a different facility. Other initiatives have also been put in place to help respond to trauma patients. One initiative is the Stop the Bleed campaign, which trains bystanders to stop extensive bleeding through the use of a tourniquet and wound packing. The 2019 legislative body passed an act requiring all public school students to take the Stop the Bleed course. Extensive bleeding can kill a person within minutes, even before first responders arrive at an emergency. Activities such as the Stop the Bleed campaign help trauma patients survive long enough to be treated by the trauma system. Over the past ten years, with support from health care providers, hospitals, state legislators, and many others, Arkansas Trauma System has successfully lowered the number of trauma-related deaths and improved the health care systemoverall. We look forward to seeing what the next ten years will bring. n Over the past ten years, with support from health care providers, hospitals, state legislators, and many others, Arkansas Trauma System has successfully lowered the number of trauma-related deaths and improved the health care system overall.