Current Trauma Status Report - Southern Nevada Health District

Survey of Other Freestanding Trauma Centers
The freestanding trauma center at UMC is one of only a few freestanding trauma centers in the nation.
For the purpose of learning about the experiences of other freestanding trauma centers The Abaris
Group contacted the following:
• Elvis Presley Memorial Trauma Center at The Med in Memphis, Tennessee
• R Adams Cowley Shock Trauma Center at the University of Maryland in Baltimore, Maryland
• Ryder Trauma Center at the University of Miami/Jackson Memorial Medical Center in Miami,
Florida
• Martin Luther King/Drew Medical Center in Los Angeles, CA
Of the four, the first two agreed to be interviewed. Their responses are presented below.
Survey of Other Freestanding Trauma Centers
Trauma Center
Elvis Presley Memorial Trauma Center
R Adams Cowley Shock Trauma Center
at The Med
Location Memphis, TN Baltimore, MD
Designation Level Level I Level I+
On-call coverage in excess of ACS standards for Level I
Affiliation University of Tennessee University of Maryland
Configuration of Center Adjacent to ED but separate and with own ICU Stand alone
Trauma System
State system has 12 trauma centers; six Level I centers; two
Level II centers; and four Level III centers
State system has 9 trauma centers: the Shock Trauma
Center, which is known as a Primary Adult Resource Center
(PARC); one Level I center; two Level II centers; and five
Level III centers
Catchment Area
Memphis also has a Level II, but this is the only Level I
center in West Tennessee; the catchment area has a radius
of 175 miles, and transfers come from other states including
Arkansas and Mississippi
Primary catchment area is approximately 50 miles, but the
trauma center takes patients from farther if they think the
patient can make it; patients also are transported from
Pennsylvania, Delaware, Virginia, and West Virginia; and
transfers arrive from all over
Governance Tennessee EMS Division Maryland Institute for EMS Systems (MIEMSS)
Works Well Governance structure; also, true dedication to trauma Good relationship with EMS at all levels; also, utilization of
state medivac helicopters run by police with paramedics on
board - they transport the whole spectrum of patients, and
the paramedics are truly active
Presents Challenge
Diversion
The way transfers are received, i.e. dumping - need to Trauma patients receive care from a wide spectrum of
provide education on what constitutes a Level I patient providers, from BLS volunteers to full-time ALS paramedics,
so it is a challenge to maintain the same level of quality and
monitoring at all levels
Only when all ORs are full, which is very rare; probably
occurred for 5 hours or less in 2003 - a summer day would
be when it might happen
Try not to go on diversion; the "trauma line" will sometimes
ask for details of a patient from the field and potentially
refer the patient to the Level I center
Capacity
Resuscitation Bays 5 10
ORs
4 on the weekend; overflow available to 8-12 elective surgery
6
ORs on weekdays
ICU Beds
23 beds in the trauma-only ICU: 8 neuro and 8 surgery
intensive care beds, plus a trauma stepdown unit of 7 beds
24 critical care beds and 24 intermediate care beds (which
can still handle ventilators)
in which 4 can by ICU
Hospital beds (licensed) 330 36 acute care beds; 118 total beds at the trauma center; 650
beds at University Hospital, where patients are occasionally
sent
Annual Trauma Volume, 2003
Trauma Arrivals 20,000 6,000
Transfers Portion 1,500 (by helicopter) 1,000
Trauma Activations 1,874 Level I activations 6,000
Trauma Inpatient Admissions 4,500 (the Level I activations and approximately 2,600 6,000 (all are admitted, and about half stay over 24 hours)
Level II and III cases)
Sources: Interviews by The Abaris Group; Tennessee trauma system information from state web site
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