Published: July 10, 2007 10:45 pm         

Golden effort: Indiana working to improve care

Regional Hospital hosts Rural Trauma Team development course

TERRE HAUTE — It’s known as the “golden hour” – the first hour after the victim of a serious injury needs some of his most critical care.

In Indiana, which was recently given a grade of D-plus by the American College of Emergency Physicians for its access to emergency medical care, an effort is under way to improve care for people with serious injuries.

“The key thing is the golden hour,” said Dr. Kayur V. Patel, chief medical officer at Terre Haute Regional Hospital, which hosted a Rural Trauma Team Development Program course on Monday.

If better first-hour care were provided, as many as 25 percent of deaths from serious injuries in the United States could have been prevented, Patel said.

Trauma, which includes serious injuries from things such as car accidents, work related injuries and gunshots, is the leading cause of death for Americans between the ages of 1 and 44, Patel said.

The emergency physicians association ranked Indiana 44th in the nation for its level of support for an emergency medical care system, according to the ACEP Web site. Illinois received a grade of C and was ranked 22nd in the nation in the same category, according to the Web site.

In an effort to improve serious injury care in the state, the Indiana Department of Health has set up a Trauma Task Force to establish a statewide trauma-care system.

Terre Haute and surrounding areas have resources to provide early serious injury care, but the state has only seven “trauma centers” – three in Indianapolis, two in Evansville and two in South Bend, Patel said.

“Our closest trauma center [to Terre Haute] is an hour away,” Patel said.

The goal of Monday’s program at Regional Hospital, which included up to 25 participants and was taught by volunteer instructors, was to help get the word out to rural providers of emergency medical services about the state’s effort and to take a first step toward establishing a single approach to serious injury care in the state, Patel said.

Participants in the program included doctors, nurses, EMS personnel and respiratory technicians, Patel said.

“[Serious injury care] begins with EMS people in the field,” said Ray Bazier, an 18-year paramedic and EMS coordinator for Regional Hospital. “We are learning some critical interventions,” he said.

Illinois has a statewide set of guidelines for handling serious injuries, said Tim Lowe, operations manager for Air Evac Life Team, a helicopter emergency medical care provider. Indiana, on the other hand, deals with life-threatening injury cases on a local basis, he said.

ACEP, which rated all 50 states on their emergency medical services, rated Indiana 47th in the nation in access to trauma centers and 34th in supply of board-certified emergency physicians.

Indiana ranked better than the national average in its number of hospital-staffed beds per 1,000 people and had one of the lowest percentage of alcohol-related auto accidents and alcohol-related fatalities as a percentage of all traffic accidents, according to ACEP’s Web site.

Monday’s program is a first step toward getting Indiana a single set of standards for handling serious injuries, Patel said. With a statewide system in place, emergency-care providers would all understand what care should be given to patients at each stage of treatment, he said.

“It’s an excellent program,” Bazier said.

Arthur Foulkes can be reached at (812) 231-4232 or arthur.foulkes@tribstar.com.