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Hospital drops trauma center

May 31, 2002|by ANDREW SCHOTZ

andrews@herald-mail.com

Starting Saturday, Washington County Hospital will stop being a trauma center, increasing the odds that local high-priority patients will be sent to hospitals in Baltimore or Bethesda.

Hospital President and Chief Executive Officer James P. Hamill said the hospital decided to give up the trauma designation because it can no longer promise 24-hour coverage for trauma surgery, a prerequisite for the hospital's level of trauma care.

Local emergency service workers responded to the news with concern.

Alan Matheny, the EMS coordinator for The Volunteer Fire Co. of Halfway, said loss of the trauma center designation could drastically affect health care and ambulance service.

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Ambulances now in use for about 45 minutes on a call may be tied up in the future for three hours or more because they will have to make longer trips to reach a trauma center, Matheny said.

Chris Amos, chief of operations for Community Rescue Service, said the commonly accepted 60-minute deadline for treating trauma patients could become dangerously unattainable without a local trauma center.

"We're going to blow the 'golden hour' out of the water," Amos said.

Maryland's emergency medical system operates on the premise that seriously injured or ill patients have about 60 minutes - the golden hour - before they go into shock that might be irreversible.

Trauma centers have been established throughout the state in an effort to ensure that trauma patients are rushed to the nearest trauma center and treatment can begin before they fall too deeply into shock.

State police helicopters often fly patients to other hospitals, but they're grounded when the weather is bad, he said.

Scrambling to figure out what comes next, ambulance companies are scheduled to meet with hospital officials this evening.

At a press conference Thursday morning, Hamill said the hospital learned of the shortfall Tuesday, when it discovered that one-fourth of the 60 trauma surgeon shifts for next month were not covered.

"They're just unwilling to put in the number of shifts that's required," he said.

The trauma surgery schedule is "a piece of paper" that could have been "worked on" and it wasn't the main issue, said Dr. Frank J. Collins, assistant director of the hospital's trauma division.

Collins said the retirement of two neurosurgeons - cutting the available pool from five to three - has strained the health care system for years.

There are "numerous issues that need to be resolved in an ongoing fashion," he said.

Asked if the incomplete trauma surgery schedule was a protest, Collins said, "The message was received."

"The neurosurgery schedule has holes in it, too," he added.

There are three levels of trauma centers for most Maryland hospitals, said Mary Beachley, director of the office of hospital programs for the Maryland Institute for Emergency Medical Services Systems, which oversees the trauma centers' designations.

At a Level III center, a trauma surgeon must be able to reach the hospital within 30 minutes. At a Level II center, at least one trauma surgeon must be at the hospital 24 hours a day.

Level I centers have standards beyond Level II centers, such as in-house residents and a research program, Beachley said.

Other trauma center requirements cover nursing, anesthesia, laboratory work and X-rays.

Washington County Hospital has been a trauma center since 1981 and a Level II center since 1998.

Without its trauma center designation, Washington County Hospital will continue to operate its emergency room, but without the guarantee of instant trauma care. Hamill said that will begin sometime Saturday.

"It leaves a big hole, a very big hole, in a highly populated area," Beachley said.

Washington County Hospital now accepts trauma patients from Washington and Frederick counties in Maryland, southcentral Pennsylvania, the Eastern Panhandle of West Virginia and part of Virginia, she said.

After Saturday, local trauma patients who would have been taken to Washington County Hospital probably will go to trauma centers in Baltimore or the Washington, D.C., area, Amos said.

He said there is discussion about having ambulances take trauma patients to Washington County Hospital so doctors can stabilize their conditions. Then another provider would transfer patients to a trauma center.

City Hospital in Martinsburg, W.Va., hadn't finalized an agreement with another trauma center Thursday afternoon, according to spokeswoman Teresa McCabe.

Jefferson Memorial Hospital in Ranson, W.Va., which is a Level III trauma center, will continue to send high-priority cases to Inova Fairfax Hospital in Falls Church, Va., spokeswoman Pam Holstein-Wallace said.

Waynesboro Hospital in Waynesboro, Pa., will still send most trauma patients to Washington County Hospital, said Dr. Bruce Foster, the director of the department of emergency medicine.

He said the same Washington County physicians likely will provide the same initial treatment.

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