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The Prescott Daily Courier | Prescott, Arizona

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6/8/2008 8:57:00 PM
Area lacks a Level One trauma center
The Daily Courier/Matt Hinshaw
A Native Air helicopter lifts off of a landing pad Saturday evening at Yavapai Regional Medical Centerís East Campus transporting a trauma patient to the Phoenix metro area.
The Daily Courier/Matt Hinshaw
A Native Air helicopter lifts off of a landing pad Saturday evening at Yavapai Regional Medical Centerís East Campus transporting a trauma patient to the Phoenix metro area.

T.M. Shultz
The Daily Courier


More than 24,000 people suffer severe injuries in Arizona each year, according to the Arizona Department of Health Services.

More than 60 percent of these injuries happen in rural areas like Prescott.

When trauma injuries happen here, a helicopter has to take patients to the nearest of seven state-certified Level One Trauma Centers that has room for them - unless the weather is bad. Those centers are in Flagstaff, Tucson, Phoenix and Scottsdale.

The American College of Surgeons - the national physicians group that sets the standards for trauma care - says if trauma patients can get to the right trauma care within the first "golden" hour after their injury, about 300 more Arizonans would survive each year.

So why doesn't Prescott's Yavapai Regional Medical Center have a Level One Trauma Center?

It's simple.

It doesn't have enough money to pay for the around-the-clock medical care necessary to qualify for the designation.

Trauma surgeons - and teams of trauma nurses, technicians and anesthesiologists - must be on site at all times. Specialty surgeons, like neurosurgeons, must be available within 30 minutes.

Most hospitals meet these requirements by affiliating with teaching programs and by having dedicated trauma operating rooms with various labs and scanning equipment, such as MRI and CAT scans, adjacent to their emergency room department.

"So there are huge costs to having these programs," said Mardy Taylor, chief nursing officer at YRMC. "You have to show that you can provide all those services at all times. It's a huge endeavor."

The seven Arizona hospitals that are state-designated Level One Trauma Centers are University Medical Center in Tucson, Flagstaff Medical Center, Scottsdale Healthcare Osborn, and the following Phoenix hospitals: Banner Good Samaritan Medical Center, Maricopa Medical Center, St. Joseph's Hospital and Medical Center, and the John C. Lincoln North Mountain Hospital.

A second Level One Trauma Center in Tucson closed a few years ago, Taylor said, "because they couldn't afford to keep all the services up and running."

Sandi Espinoza, Taylor's counterpart at the Flagstaff Medical Center, said that in addition to state certification, Flagstaff's hospital is working hard to get additional Level One Trauma Center certification from the American College of Physicians. That additional certification should be in effect by the end of the year, Espinoza said.

"There really isn't much difference except the American College of Surgeons is much stricter," Espinoza said.

When an accident happens in the Prescott involving head injuries or multiple traumas, Taylor explained, the patient falls into the level one criteria and needs level one care.

Everyone involved in emergency service in Arizona understands what the criteria are, Taylor said.

The emergency workers then call YRMC on a special phone. An emergency room doctor either confirms the standard protocol or authorizes a change, Taylor explained.

At the same time, dispatch calls for the nearest helicopter.

The hospital has one Native Air helicopter stationed at each of its two campuses, Taylor said.

Air Evac has a third helicopter stationed at Prescott's Earnest A. Love Field.

In the past few years, the hospital has had about one person a day flown to a Level One Trauma Center from the Prescott area, Taylor said.

"(Those numbers) may be creeping up a little bit with the increasing population," Taylor said.

Contact the reporter at tshultz@prescottaz.com


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Reader Comments

Posted: Tuesday, June 10, 2008
Article comment by: kghkk

they needed a new hospital because they couldnt expand the one in prescott because the ground it sits on cant withstand another floor. there isn't enough hospital rooms for all the ppl coming here. the birthing center for sure gets over cramed. the hospital in pv will get more staff as more and more ppl start needing care there with the growing population. the east campus already needed to open the third floor, it wasn't needed a yr ago. the money spent on the east campus was needed. it couldn't go to a new trauma unit when the west campus couldn't hold more ppl.

Posted: Monday, June 09, 2008
Article comment by: gbaske

One of the effects of not having a level one is the incredible cost of helicopter transport to Phoenix. I know of one case of a traffic accident victim who had to be sent to Phoenix from Prescott Valley who was billed $22,000. GAD!!

Posted: Monday, June 09, 2008
Article comment by: Me

It's about time this article was written. Now perhaps it will lay to rest all the nay sayers who oppose YRMC as a qualified Health Care center. Just because they can't treat everyone, doesn't mean they can't treat anyone.

Posted: Monday, June 09, 2008
Article comment by: Derek

Looks like it's pretty costly to pay a trauma team (surgeon, anesthestiologist, OR team) to be on site 24/7 for an average of one case/day. If only one hostital in Tucson has level 1 (UofA) it probably isn't going to happen in Prescott. We do have 24/7 helicopter service here to Flag/Phx and will soon have a neurosurgeon, so maybe every trauma case won't have to be flown out in the future.

Posted: Monday, June 09, 2008
Article comment by: drcrutch

The head line to this article is misleading: "Area lacks a Level One Trauma center." Actually, as the body of the article points out, the STATE has seven (7) and would have had 8 if, financially, Tucson Medical Center's trauma unit could have remained viable. It is actually the American College of Surgeons that designates a hospital as a level one trauma center--not really the State. While the State may "recognize" such a designation, a hospital is NOT a fully-accredited level-one trauma unit until the American College of Surgeons so designates it. Trauma is a "regional" entity; most of Arizona's (and the US) hospitals are NOT trauma-designated hospitals because trauma care is SO expensive and goes unpaid--by the State and by the patient--who can't afford the HUGE funds required to resusitate a head injured patient--or a multiple-gun-shot wound victim (from, say, an AK-47). Most surgeons, today, would tell you emergency room care goes "unpaid" about 30% of the time and trauma-care goes unpaid about 90% of the time. Regionalization of trauma care is a mandate--since the costs are prohibitively expensive--and would require a large teaching, research hospital to support the loss of time, funds, and physicians that goes with the designation. It is a safe assumption that Native Air, annually, loses thousands $$$$ from unpaid transports. A trauma center, at YRMC, is not desired, not staffed, not paid, without intra-hospital support (no trauma ICU, no neurosurgery TEAM, no neurosurgical ICU, etc.) and, at this time, is not wanted by most of the medical staff. So the headline is wrong: The AREA does have a level one-trauma center--and it is Flagstaff--or John C. Lincoln (and, until Flagstaff receives their ACS [American College of Surgeon] approval, technically, it is not a level-one trauma center. When trauma care is 100% reimbursed, only then, could YRMC even HOPE for such a desgination.

Posted: Monday, June 09, 2008
Article comment by: Pete

Thank you T.M. Shultz for explaining the complexity of medical care in the area. I have a question.Why building a campus in P.V. some 10 miles from Prescott? The milions saved would surely provide a first class surgeons for years to come. Now we have two hospitals with no people to run them.Is it as usual the shortsighted P.V. Town manager?Or is more spread corruption involving "we all know" who.



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