Current Trauma Status Report - Southern Nevada Health District

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<strong>Trauma</strong> Glossary Source: <strong>Trauma</strong> System Agenda for the Future (NHTSA) and The Abaris Group bypass – transport of an EMS patient past a normally used EMS receiving facility to a designated medical facility for the purpose of accessing more readily available or appropriate medical care citizen access – the act of requesting emergency assistance for a specific event communications system – a collection of individual communication networks, a transmission system, relay stations, and control and base stations capable of interconnection and interoperation that are designed to form an integral whole. The individual components must serve a common purpose, be technically compatible, employ common procedures, respond to control, and operate in unison. designation – formal recognition of hospitals as providers of specialized services to meet the needs of the severely injured patient; usually involves a contractual relationship and is based on adherence to standards disaster – any occurrence that causes damage, ecological destruction, loss of human lives, or deterioration of health and health services on a scale sufficient to warrant an extraordinary response from outside the affected community area dispatch – coordination of emergency resources in response to a specific event dry runs – the number of calls for an emergency medical services provider that are cancelled en route to a scene emergency medical services for children (EMS-C) – an arrangement of personnel, facilities and equipment for the effective and coordinated delivery of emergency health services to infants and children that is fully integrated within the emergency medical system of which it is a part emergency medical services system (EMS) – a system that provides for the arrangement of personnel, facilities, and equipment for the effective and coordinated delivery of health care services in appropriate geographical areas under emergency conditions EMS diversion – occurs when a hospital’s emergency department cannot accept any additional patients from ambulances. The ED goes on “divert” and the ambulance must take the patient to an ED not on divert. EMS provider – ambulance providers and fire departments (same as pre-hospital provider) Emergency Medical Treatment and Labor Act (EMTALA) – (Source: American College of Emergency Physicians (ACEP)) A federal law enacted by Congress in 1986 as part of the Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1985 (42 U.S.C. §1395dd). Referred to as the "anti-dumping" law, it was designed to prevent hospitals from refusing to treat patients or transferring them to charity or county hospitals because they were unable to pay or had Medicaid coverage. In effect, EMTALA designated emergency departments as one of America's most important health care safety nets. Under the law, patients with similar medical conditions must be treated consistently. The law applies Page 89
to hospitals that accept Medicare reimbursement, and to all their patients, not just those covered by Medicare. Congress has made aggressive enforcement of EMTALA a priority, with almost as much money assessed in penalties in 2000 ($1.17 million) than in the first 10 years (about $1.8 million) of the statute's existence, according to the Office of Inspector General (OIG). Nevertheless, in the past 2 years, EMTALA fines declined. Approximately $300,000 in fines was collected from 10 hospitals between October 1, 2002 and March 21, 2003, but no physician settlements were reported. Hospitals have three basic obligations under EMTALA. First, they must provide all patients with a medical screening examination to determine whether an emergency medical condition exists. Second, where an emergency medical condition exists, they must either provide treatment until the patient is stabilized, or if they do not have the capability, transfer the patient to another hospital. Third, hospitals with specialized capabilities are obligated to accept transfers if they have the capabilities to treat them. Medical care cannot be delayed by questions about methods of payment or insurance coverage. Emergency departments must post signs that notify patients and visitors of their rights to a medical examination and to receive treatment. field categorization (classification) – a medical emergency classification procedure for patients that is applicable under conditions encountered at the site of a medical emergency first responder – fire department personnel who are typically trained at the EMT-Paramedic level to assess and provide the initial care to an injured person. First responders do not typically transport the patient, they only treat. If transport is necessary, an ambulance will be dispatched. inclusive trauma care system – a trauma care system that incorporates every health care facility in a community in a system in order to provide a continuum of services for all injured persons who require care in an acute care facility; in such a system, the injured patient's needs are matched to the appropriate hospital resources injury – the result of an act that damages, harms, or hurts; unintentional or intentional damage to the body resulting from acute exposure to thermal, mechanical, electrical or chemical energy or from the absence of such essentials as heat or oxygen injury control – the scientific approach to injury that includes analysis, data acquisition, identification of problem injuries in high risk groups, option analysis and implementing and evaluating countermeasures injury prevention – efforts to forestall or prevent events that might result in injuries injury rate – a statistical measure describing the number of injuries expected to occur in a defined number of people (usually 100,000) within a defined period (usually 1 year). Used as an expression of the relative risk of different injuries or groups lead agency – an organization that serves as the focal point for program development on the local, regional or state level level I trauma center – the highest level of care. They also conduct research and maintain volume performance standards. Page 90
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SOUTHERN NEVADA CURRENT TRAUMA STAT
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Table of Contents Executive Summary
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Chronology of Trauma Care in Southe
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Exhibit 33 - Map Displaying Trauma
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• From January through April 2004
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Clearly trauma center staffing and
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A series of focus groups was also c
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• Information Management • Fina
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(This study did not attempt to meas
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County Health District Board of Hea
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on an average length of stay of 3.4
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Exhibit 8 - Projected Population Ch
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Trauma Stakeholder Interview Result
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three years, and felt that a Level
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EMS providers ranked Acute Care Fac
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Town Hall Meeting Comments A series
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(CAAS) and the air ambulance provid
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Triage Criteria The determination o
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With the exception of the year 2000
Page 39 and 40: Exhibit 20 - Trauma Patients by Age
Page 41 and 42: The following chart shows that abou
Page 43 and 44: Exhibit 27 - Trauma Ground Transpor
Page 45 and 46: E codes enable the classification o
Page 47 and 48: The day of the week with the greate
Page 49 and 50: A different view of the 2002 trauma
Page 51 and 52: As part of The Abaris Group’s tra
Page 53 and 54: The table below summarizes the key
Page 55 and 56: All EMS and ED stakeholders appear
Page 57 and 58: Exhibit 43 - Specialty Physician Co
Page 59 and 60: Clark County Health District has id
Page 61 and 62: Trauma Center Standards by Level Th
Page 63 and 64: Nevada Trauma Registry Submission R
Page 65 and 66: Trauma Center Capacity Benchmark Da
Page 67 and 68: ED Diversion Hours by Hospital ED D
Page 69 and 70: • This region would not pass a ta
Page 71 and 72: • Instead of calling it a tax, we
Page 73 and 74: Mesquite Town Hall Meeting The foll
Page 75 and 76: North Las Vegas Town Hall Meeting T
Page 77 and 78: Las Vegas Town Hall Meeting The fol
Page 79 and 80: Trauma Center Funding Comparison St
Page 81 and 82: Los Angeles County, CA Los Angeles
Page 83 and 84: Chronology of Trauma Care in Southe
Page 85 and 86: January 22, 1999 December 10, 2001
Page 87 and 88: List of Trauma System Assessment St
Page 89: Southern Nevada Trauma System Asses
Page 93 and 94: ehabilitation - services that seek
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Current Trauma Status Report - Southern Nevada Health District

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