Imagine your son or daughter is riding their bicycle in rural Arizona when a car swerves and crashes into them, causing a severe head injury. They are clinging to life.
Until several years ago, if this injury had happened anywhere other than Flagstaff, Tucson or Phoenix, your child’s chance of receiving specialized trauma care within the first hour – the “Golden Hour” – would have been slim. Thankfully, much has changed in the last few years.
Developing an excellent statewide trauma system has been a top priority for the Arizona Department of Health Services, and we’ve come a long way in a short time. A decade ago, folks that were badly hurt in Arizona’s rural and frontier areas had to be transported long distances in order to receive trauma care. The lack of a statewide trauma system also caused prolonged transport times to the Level I trauma centers in Phoenix, Tucson and Flagstaff, often resulting in expensive and sometimes avoidable air ambulance trips.
In 2006, we invited the American College of Surgeons (ACS) to bring trauma system experts to Arizona to assess our system and offer recommendations for improvements. Among its recommendations, ACS advised that we: bring rural hospitals into the trauma system as Level IV trauma centers; strengthen the State’s trauma registry, a database used to collect important information regarding serious injuries; and periodically assess our system and make necessary updates to our state trauma plan.
Over the last three years, our ADHS team has been able to recruit 13 rural hospitals into our trauma system, ensuring that every trauma victim has timely access to good trauma care. Our State trauma registry has been strengthened by undergoing validation checks and audits and is now arguably the best registry in the country, allowing us to conduct all kinds of research to improve care across the state.
Arizona’s trauma system today bears little resemblance to our system just a few years ago, and like any system, it’s important to re-assess how we are doing in order to ensure that it continues to meet the needs of our communities. That’s why we’ve arranged to have the ACS return this fall in order to take a look at the progress we have made over the last several years. We’ll continue to get feedback from our trauma system stakeholders on the best way to move forward so that we can continue to provide the best care for those injured in Arizona.
Survival from a severe injury shouldn’t depend on where you live; we’ve already implemented changes to make sure of that. Now it’s time to take Arizona’s trauma system to the next level and make it into the world-class system that Arizonans deserve.
1. What is a Trauma System?
A trauma system is an organized and coordinated method to care for injured patients involving 911 dispatch centers, first responders, ambulances, local hospitals, trauma centers, rehabilitation facilities and injury researchers. In other words: a trauma system makes sure that the patient receives the right care at the right place in the right time.
2. What is a Trauma Center?
A hospital designated by the Arizona Department of Health Services that meets State or ACS licensing criteria.
There are four levels of trauma centers:
- Level One Trauma Centers are academic research centers with all the resources, staff, education and support services necessary to care for the most severely injured patients. (We have 8 – one in Flagstaff, one in Tucson and five adult and one pediatric in Phoenix).
- Level Two Trauma Centers have all of the resources, staff, education and support services as a level I trauma center without the academic and research requirements. There are no level two trauma centers in Arizona.
- Level Three Trauma Centers have fewer resources, staff, and education and support services than a level two, and are able to care for mild and moderately injured patients, perform emergency surgery and stabilize and transfer critical patients to a level one hospital. Currently, there are two provisional Level Three trauma hospitals in Arizona.
- Level Four Trauma Centers have basic resources, personnel, education and support services. They are qualified to admit patients with minor injuries and stabilize and transport patients with critical injuries to a higher level of trauma care. There are 14 level four trauma centers in Arizona.