erraticating trauma alerts

[sevenball]

Hey all,

Ran across a great debate subject the other day at work. I was talking with a fellow employee about calling trauma alerts when he told me that our state was looking into eliminating them all together. Their justification for all this was that we (emt's) didn't call them properly, and in the long run, didn't do much to change the overall mortality rates.

Now, I really don't call them all that often, even if I think it's necessary, but I was really offended by all of this. How could some desk jockey tell me that I didn't know the difference between a surgical candidate, and one that needed some boo boo tape. Maybe I'm overly sensitive on this one, but I was enraged.

[air.stump]

I wouldn't take it personally. Some of those desk people have real EMS backgrounds and are probley responding to hospital requests. It would be interesting to see the stats the hospitals are referring to. If you are transporting to a level 1 center then what kind of time change are we talking here?

[sevenball]

Thats the thing! I could see if there were a large amount of level 1 centers around, but there aren't. The majority of hospitals are level 3, maybe a level 2 here and there. So clearly, there is a need for early notification of the trauma team so they can get in.

[MSDeltaFlt]

There's another point to this story. When we call trauma alerts, depending on the level called, that starts dominoes rolling that some may not be aware. The on call MD's have certain time limits to be at the bedside, depending on the area. My area, a level I means that the on call has 30 mins to be at the bedside. A level II just needs to be scanned within 30min.

Now when a physician gets called out for a level I on an actual level II or III at 2 am enough times, they will get pissed off enough to complain to the state. MD/DO opinions carry a bit more weight than ours. And the state ends up having to do as they are told. It's a big political "broo-ha-ha".

Should they be thrown away completely? No. It just means that EVERBODY, MD's/DO's included for their imput, need more education and training.

[firedoc5]

Unfortunately, for a time, the Trauma Centers seemed to get mad or annoyed that we had brought in a major trauma, like it was our fault the pt. got hurt in the first place. At one point we had the priority center in our area tell us to take them to the other lower level center across town. About 1-2 hrs. later we would have to transfer the same pt. to them anyway. It was very frustrating. We did finally get all that ironed out. But I think some of the staff were called on it and a few were "sent to other depts." From what I later found out it was based by one doc's stance, and he was the County Coroner. But still never found out what his stance exactly was.

[Flasurfbum]

That is one of the more ridiculous things that I have heard.

We will get reamed out if we take a questionable pt to a lesser care facility.

The docs, and trauma teams here are excellent. They would rather deal with a hundred drama alerts then have the medics downgrade one true trauma alert, and we are encouraged to call them as we see fit.

[VentMedic]

Almost every state has a trauma registry to which hospitals report their data. This data can then become part of the national trauma registry.

Check your state's trauma registry website to see if there are any changes in the hospitals' reporting system or criteria.

On the other hand, the hospital may be still reporting traumas to the state but may be revamping their internal activation system. Just for the page for a trauma alert to be activated, a $4000 - $5000 charge is added. If the only injury the patient suffered is a sprained ankle but a trauma alert was called, the patient and/or insurance is still billed the extra $5k in addition to the other charges. There have been numerous news articles to make the public aware of what their ED bills actually contain.

[BEorP]

Hey all,

Ran across a great debate subject the other day at work. I was talking with a fellow employee about calling trauma alerts when he told me that our state was looking into eliminating them all together. Their justification for all this was that we (emt's) didn't call them properly, and in the long run, didn't do much to change the overall mortality rates.

Now, I really don't call them all that often, even if I think it's necessary, but I was really offended by all of this. How could some desk jockey tell me that I didn't know the difference between a surgical candidate, and one that needed some boo boo tape. Maybe I'm overly sensitive on this one, but I was enraged.

Since I think that your "desk jockey" comment was a bit too much I'm going to ask you an important question about the bolded statement. Do you have a study that shows that it does improve patient outcomes? Just curious.

[firedoc5]

That is one of the more ridiculous things that I have heard.

We will get reamed out if we take a questionable pt to a lesser care facility.

The docs, and trauma teams here are excellent. They would rather deal with a hundred drama alerts then have the medics downgrade one true trauma alert, and we are encouraged to call them as we see fit.

Tell me about it. That was in the mid '80's so I know a lot of people's priorities tend to have got screwed up, especially with the older docs at the time. They just didn't understand trauma system. Sitting steadfast in their own ways I think they wanted to mess with what they didn't want to.

[sevenball]

be or p,

No, I don't. That was kind of my point. It was the hospitals stance that it did nothing to help the pt. in the long run. I have no numbers to support that claim, nor can I find any out there. So my question is, why do they feel it necessary to tell us this, if they cannot support that claim with facts.

As for the desk jockey comment, sorry if it offended you, but lets face it, EMS has changed. If someone has been riding a desk for the last 15 years, they are out of touch. Much like the politician who has been in senate for 30 years, there is no way they can relate to a street medic, or common man. You have to be able to work the streets to know the caliber of medic that is out there. Granted, the system isn't perfect, this I know, but certainly, we are able to think outside the box alot better now than we ever had in the past.