Developing a Trauma System Anywhere in the world

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Mike


You are to be congratulated for your leadership and your good results

We have the same experience here at Charity Hospital but without your
length of data. We started later than you but followed your lead and
that of Brent Eastman and Don Trunkey. We bring in trauma patients
directly from the surrounding 10 parishes (counties) bypassing non
trauma facilities. We use the ACS anatomic and physiologic ( Step 1 & 2
in the New triage scheme)  for bypass and direct transport to The Trauma
Center. Mechanism of injury is first assessed in the local hospital and
the transferred to us if trauma center is needed. About 80% of the MOI
goes home within 6 hours most of the rest can be handled at the local
facility. We have significantly reduced the mortality as have you.

Norman
 
Norman McSwain MD
Professor, Tulane School of Medicine
Trauma Director, Charity Hospital Trauma Center
norman.mcswain at tulane.edu
504 988 5111

-----Original Message-----
From: trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org] On Behalf Of Sise, Mike MD
Sent: Monday, March 30, 2009 8:11 AM
To: trauma-list at trauma.org
Subject: Developing a Trauma System Anywhere in the world

In San Diego we are about to pass our 25th anniversary with a trauma
system. The twittering about the recent high profile death in Canada is
an exact replica of stories from San Diego 30 years ago with the names
and a few particulars changed. We can predict what prehospital, local
hospital, and tertiary centers will say about this unfortunate event. We
suffered through all the same recriminations before we started our
system. 
 
Here's what we learned - we agreed to identify injured patients at the
scene who needed trauma evaluation and care and rapidly transport them
past local hospitals to one of six hospitals with a general surgeon
in-house with all of the surgical subspecialists on 30 minute back up.
The six hospitals were relatively small to medium sized (225 - 325 beds)
compared to the traditional notion of a trauma center (500-750 beds).
They met the commitment of having a surgeon present with access to the
OR, ICU, CT scan, etc. 
 
The preventable death rate from trauma in San Diego County in 1982 was
20%. In 1984-1985, it dropped to 3%.
 
We offer our best support and hopes that injured people everywhere
around the world can be taken rapidly to a surgeon who has the resources
to save them from their injuries if at all possible.
 
Mike Sise
San Diego

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