Current Trauma Status Report - Southern Nevada Health District

All EMS and ED stakeholders appear frustrated about the problem. The FAB and MAB, in conjunction
with the Clark County Health District, have agreed to test eliminating the “emergency department
closure” protocol and initiated a 90-day pilot on April 1, 2004. During this period, hospitals will not be
able to close for one hour as previously allowed under the protocol. Instead, all patients are to be
transported to the facility of their choice or to the closest facility, with the exception of trauma and
burn patients. EMS providers will utilize the EMSystem EMS Offload Advisory levels to advise patients
about the status of waiting times at the emergency departments when the patient is choosing a facility.
Although this pilot project prohibits diversion, if a facility declares an internal disaster, all EMS traffic
including inter-facility transfers to that facility will stop. Early indications are that the pilot test is
having a positive impact.
Information Systems
There are two main components that make up a trauma information system: a trauma registry and
prehospital data. In the case of Southern Nevada there are two trauma registries, one maintained by
the Nevada State Health Division and another registry maintained by UMC. The registry kept by UMC
captures more data than what is required by the State.
With respect to prehospital data, each provider maintains their own database. The fire providers
maintain electronic databases, while the ambulance providers maintain paper databases.
In accordance with NRS 450B.810, NAC 450B.620, NAC 450B.645, and NAC 450B.766, State EMS, in
cooperation with Clark County Health District EMS office, have adopted standards for prehospital data
collection. Computer software and a web-based server have been provided for collecting and storing
prehospital run reports and data obtained from all Nevada permitted EMS/Fire agencies.
While not every agency is required to install and utilize the provided software, each will be required to
submit the required data elements in a format that will allow uploading to the web-based server. The
rollout utilizing the web-based server is scheduled for July 2004. Las Vegas Fire and Rescue and local
ambulance providers are expected to adopt a new software system called Roam IT allowing for a
standardized electronic reporting of the prehospital care report to be in place by April 2004.
ED data reporting is voluntary and not conc lusive. However, State regulation does require the
reporting by all hospitals of any trauma care provided. While it is mandatory that hospitals report
trauma cases to the Nevada Trauma Registry, the reality is that many hospitals find it difficult to meet
the requirement due to staffing issues and thus the registry suffers. The data the State does receive is
published in an annual report. In addition to the mandatory trauma reporting, all hospitals must
submit the Uniform Billing 92 Hospital Discharge data set.
Other data sources exist, but there is not a data warehouse for EMS/trauma data in Southern Nevada.
State Trauma Registry
All hospitals are required by NAC (NRS 450B.120 and 450B.238) to submit data to the State on trauma
patients. The State provides the definitions on patient types and data fields for inclusion in the trauma
registry. Hospitals must submit quarterly reports to the Nevada State Health Division within 60 days
after the end of the quarter. The Nevada State Health Division then publishes an annual report by July
1 for the previous calendar year. The most current report was published on November 12, 2003 and
provides data for 2000 through 2002.
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