The effectiveness of a State’s EMS and Pre-Hospital & Trauma System makes the difference when it comes to saving lives (and quality of life) from injuries. Injuries are the leading cause of death for Arizonans from age 1 to 44- so you can see how important it is for states to have an effective EMS & trauma system. But what is it? The easiest way to picture the pre-hospital and trauma system is to look at it as a continuum.
Let’s start with a car crash. The first link in the chain is the bystander that knows to call 911 first and then starts helping any way they can. The next step is 911 dispatch. Dispatcher education and training is crucial in coaching the Good Samaritan and getting the paramedics and EMTs on the way. Paramedic & EMT training and effectiveness is the next link in the chain. Good awareness of the latest science and practice results in good interventions by paramedics and EMTs in the field. Next is the transport. We need a good well-regulated network of ambulance providers that know how to properly triage and transfer patients to the right place at the right time- taking into consideration the severity of the injury, distance to facilities, traffic, and other factors. Solid on-line medical direction is also a key at this level. Finally, it takes a solid network of trauma centers (specialized and certified hospitals) that can handle a wide variety of injuries in an effective way- along with good post-surgery rehabilitation within medical facilities.
Complicated- I know. But it really is a system. Each component plays a role in improving the outcome of a severe injury. The bottom line is that the public, 911 dispatchers, first responders, the ambulance team that transports the injured to a trauma center, the specialized care provided at that center, and the post-surgery rehabilitation within a medical facility are critical components of a state’s trauma system.
Developing an excellent statewide EMS and trauma system has been one of our top priorities and we’ve come a long way in a short time. We’ve been working with stakeholders to implement system improvements including dispatch training, performance improvement, mode of transport decisions and data quality checks and everything in-between.
For example: one of the programs we have put in place is our Premier EMS Agency Program. The EMS Agencies that meet our criteria are listed on the website above. You can check out our participation materials including our; Schematic; Application; Handbook; and Data Dictionary. By bringing in more EMS partners to the Premier EMS Agency Program- we’ll be able to continue to make Arizona’s pre-hospital system the envy of the nation.
We’ve also recruited 17 rural hospitals (up from 0) into our trauma system in the last 3 ½ years. For the first time, Arizona’s rural trauma patients have timely access to good trauma care. Our State trauma registry has been strengthened by undergoing validation checks and audits and is now one of the best registries in the country, allowing us to conduct all kinds of research to improve care across the state.
