Letter to the Editor: Allamakee County's trauma system

To the Editor:
I was at a recent Board of Supervisors meeting discussing ATV usage within Allamakee County when a comment was made about the lack of a trauma center within Allamakee County. At that time, I started thinking it is time for some updated education to the citizens of Allamakee County. When it was published in the paper, it definitely confirmed the fact that education is needed. Being in the healthcare field probably makes it easier for me to understand but hopefully others will understand after finishing this article.
First of all, we have a large trauma system, not just a center. This system encompasses everything from education on how to avoid accidents, the pre-hospital care of a victim, stabilization of a victim at the different levels of hospitals and then the long term care that may be required. Several years ago the State of Iowa required that all hospitals and EMS services do an evaluation of their facilities as to which set of criteria they would fall into. When Veterans Memorial Hospital completed their assessment we fell into a Level IV trauma hospital. All the area hospitals in our tri-state area also fell into this same category. Not to bore everyone with a lot of facts and figures, but the main difference between a Level IV and a Level II is the fact that the Level II and III has to have a surgeon and/or neuro surgeon on staff and available 24 hours a day, seven days a week. Only the larger metropolitan hospitals can provide that and even they sometimes struggle. A level I is to have a surgeon along with being a teaching and research center. Every facility has to have a designated trauma team that can be activated and is ready to provide care. Pre-hospital personnel are trained to recognize these situations, and call prior to arrival so the team is ready.
Being a Level IV trauma facility still provides qualified, well-educated physicians and staff to quickly, safely diagnose, provide appropriate treatment and transfer a patient to a higher level of care. The physicians receive training in Advanced Trauma Life Support (ATLS). Nurses have a course required called Trauma Nurse Core Course  (TNCC) and pre hospital staff train in Pre Hospital Trauma Life Support (PHTLS) course. All these courses provide quality education that is required of staff to maintain and makes all entities from start to finish work together to provide very high quality patient care.
When a patient needs to be transferred to a higher level of care, this can be completed quickly depending what is best for the patient and family. Transfers are usually completed by ground or air ambulances depending on the severity. The other positive is that if a person is not from this area and requires more treatment, they can be transferred to facility that they are familiar with and closer to their family. Whether by ground or air, the patient will receive an extremely high level of care from qualified personnel.
There are also criteria that need to be followed regarding time required to get a patient to another facility, if necessary. Please keep in mind that there are variables that are out of our control, but from the time of discovery or arrival to the facility, we work rapidly and effectively to get injuries diagnosed, any life threatening injuries stabilized, and make arrangements for appropriate and safe transport. This process is continually monitored and improvements made to streamline the process. One of the processes is done by the Iowa Trauma Team which consists of trauma coordinators from each facility. They meet on a regular basis to discuss, evaluate and recommend these changes at the state level. A trauma committee is designated at every facility that monitors and recommends policy changes for improvement at the local level. Additionally, every trauma facility must recertify every three years to maintain their current level. Level I and II require actual site visit inspections and Level III and IV require intense paper applications with proof of completed requirements.
The trauma system is a large complex system that is state and federally implemented to provide exceptional care to anyone, whether urban or rural. It covers all injuries from the head to the toes. And whatever the injury is or how it occurred, Allamakee County has a trauma system that will provide care to each and every citizen and those traveling through or visiting.

Sincerely,
Jeff Mitchell, PM
Paramedic/EMS Supervisor
Veterans Memorial Hospital