Point: More trauma centers could be the difference between life and death

By Paul Nelson

Tuesday, June 14, 2016 | 2 a.m.

Las Vegas does not have an adequate trauma system to meet the community’s growing needs. We have an opportunity to take an important step in positively addressing this need, and, for the life of me, I can’t understand those who would oppose additional access to life-saving trauma care.

Please allow me to explain. Just this year we have seen an unprecedented spike in violent crime, and the number of homicides has more than doubled over the same period in 2015. Moreover, the Las Vegas community has a disproportionate rate of automobile crash fatalities — the fifth worst rate of the country’s 53 largest cities. Authorities have pointed out that Las Vegas is a prime terrorist target. Further, we represent one of our country’s most rapidly aging populations, where falls account for the vast majority of trauma cases among seniors. And, as Clark County’s population has grown by more than 40 percent over the past 12 years, our county’s trauma centers have not kept pace. We have only three trauma centers serving 8,000 square miles and our more than 2.3 million residents and tourists on any given day. Travel times have increased with traffic congestion. Resources at existing trauma centers are stretched, and patient volumes are expected only to continue to rise.

Why should these facts matter to you? Because a friend or loved one may one day be in need of trauma care and minutes can be the difference between life and death. Research shows survival chances increase significantly when trauma patients are cared for in a trauma center and when treatment is received within the “golden hour,” or the first 60 minutes of injury. During my 32 years as a surgeon, I’ve seen all types of injuries; however, over and over again, the single most important long-term advantage for a trauma patient is being treated in a verified trauma center.

Fortunately, MountainView Hospital and Southern Hills Hospital and Medical Center have applied for level III designation to help increase the region’s emergency preparedness and expand trauma care resources. Opening these two trauma centers will go a long way toward ensuring adequate trauma resources are available across northern Clark County, with minimal impact on University Medical Center and Sunrise Hospital and Medical Center, the local level I and level II trauma centers. They will provide shorter transport times to definitive care, allow for lower level trauma cases to be handled locally while UMC and Sunrise focus on more severe cases, and allow trauma patients to recover closer to home. The hospitals are investing the capital necessary to solve trauma access issues at no taxpayer expense.

MountainView, in conjunction with Sunrise, is set to open training programs in surgery and internal medicine that will further the postgraduate education of medical doctors. Surgery residents will rotate at both these institutions, and the programs will raise the quality of care by bringing more physicians to the bedside of injured patients.

Both of these hospitals are part of the Hospital Corporation of America system, which operates proficient trauma centers across the country. Patient outcomes are better than the national average, including higher survival rates and shorter lengths of stay in the hospital. These indicators make a difference in ensuring the best quality of life for trauma patients following discharge from the hospital.

Having served as the trauma surgeon for level I and II trauma centers in an urban setting for a number of years, I fully understand the responsibility to provide care for the entire community, regardless of ability to pay. I appreciate the distinct value of other trauma hospitals in the community that provide the same quality care to indigent patients. Fortunately, HCA has one of the most generous charity care and uninsured discount policies in the country, and we do not charge trauma activation fees for the uninsured. Activation fees are generated only when an ambulance delivers the patient to the hospital, notifies the trauma team prior and the patient is covered by a commercial payor. It is expensive to provide 24/7 specialized medical staffing and cutting-edge equipment for trauma care, and HCA’s activation fees are consistent with the costs to provide that level of service.

A 21st-century trauma system is needed to ensure access to trauma care across the Las Vegas Valley. I hope the Southern Nevada Health District carefully considers these facts and approves the new level III trauma centers at its June meeting. Las Vegas requires and deserves no less.

Dr. Paul Nelson is the medical director of graduate medical education at MountainView Hospital.