Community hospital to trauma center.

Abstract

The Committee on Trauma of the American College of Surgeons published a report in 1976 charging hospitals to provide care for seriously injured patients. Implementing an effective emergency care/trauma system in a not-for-profit community hospital was a task that demanded leadership, substantial time, and commitment. The building process could not have begun without a strong commitment from the hospital's board, administration, medical staff, and nursing service. Initially, the operating rooms, radiology, intensive care units, and emergency departments were renovated or replaced. General surgeons and surgical subspecialists committed to trauma care were recruited. Emergency department (ED) physicians were upgraded and resident rotations in the ED were begun. A ground and helicopter transport system was initiated; dispatch was centered in the ED. Educational programs in prehospital critical care and stabilization for flight nurses and EMT's were developed. The operating rooms began 24-hour service with in-house anesthesia coverage. Radiology provided 24-hour coverage of specialty services. Physicians began in-house coverage of the critical care units. The department of surgery developed a trauma section to encompass all the general surgeons and subspecialty physicians in emergency care. Monthly in-service programs were begun for the intensive care unit (ICU) and ED nurses. In each of the past 3 years, a 2-day trauma update program has been provided to the regional Emergency Medical Services (EMS) and medical community. The dedication and commitment of many people during the past 5 years has resulted in a sound system of emergency/trauma care in a community hospital.