Chesterton Tribune

 

 

Under state law certain injuries require EMS to take patient to trauma center

Back To Front Page

 

By KEVIN NEVERS

Why would an ambulance service provider serving Duneland ever transport a seriously injured person, in grave danger of dying, to a hospital outside Duneland, to one, say, in Lake County?

That was the question an indignant reader put to the Chesterton Tribune on Friday afternoon, prompted by Thursday’s story on the elderly Porter woman who was struck by a freight train on June 22 at the North Jackson Blvd. grade-crossing. That woman was transported from the scene directly to Methodist Hospital Northlake Campus in Gary, where she later succumbed to her injuries.

Why, the reader wanted to know, was the woman transported to a facility in Gary and not to Porter Regional Hospital (PRH), located as it is just down the road on U.S. Highway 6 in Liberty Township, where more immediate access to medical treatment might potentially have saved her life?

The short answer to that question is this: because the paramedics had no choice in the matter, were legally obligated to transport their grievously injured patient to Methodist Northlake, and would have exposed themselves to liability had they not done so.

Under the “Trauma Field Triage and Transport Destination Protocol” established by 836 Indiana Administrative Code 1-2.1, ambulance service providers are required to (1) assess the condition of an injured person using “Guidelines for Field Triage,” then (2) determine whether that person needs “trauma center care,” and finally (3) transport that person to the nearest trauma center, unless transport time exceeds 45 minutes or in a paramedic’s judgment the person’s “life will be endangered if care is delayed by going directly to a trauma center.

PRH is not an officially designated trauma center. The nearest one to Chesterton--by ground transport--is Methodist Northlake. There are three others to which persons who sustain traumatic injuries in Porter County might also be transported by air: the University of Chicago Medical Center; Advocate Christ Medical Center in Oak Lawn, Ill.; and Memorial Hospital of South Bend.

The following injuries automatically trigger a patient’s transport to the nearest trauma center:

* All penetrating injuries to head, neck, torso, and extremities proximal to elbow or knee.

* Chest wall instability or deformity.

* Two or more proximal long-bone fractures.

* Crushed, degloved, mangled, or pulseless extremity.

* Amputation proximal to wrist or ankle.

* Pelvic fractures.

* Open or depressed skull fracture.

* Paralysis.

* Falls of 20 feet or more (or of 10 feet for children).

* High-risk auto crash in which there’s been ejection or another occupant’s death in the same passenger compartment.

* Auto vs. pedestrian/bicyclist thrown or run over or hit by a vehicle traveling at speeds greater than 20 miles per hour.

* Motorcycle crash at speeds greater than 20 mph.

The following factors could cause paramedics to decide to transport an injured person to a trauma center even if none of the preceding conditions is altogether applicable:

* The patient is older than 55.

* The patient is a child.

* The patient has a bleeding disorder or is prescribed anticoagulants.

* The injuries include burns.

* The patient is more than 20 weeks pregnant.

“The bottom line is that the paramedic must follow protocol (and there is protocol for everything),” Chesterton Fire Chief John Jarka told the Chesterton Tribune. “Paramedics must make the decision on transport while knowing their license could be taken away if the wrong decision is made.”

A trauma center officially designated as such by the American College of Surgeons (ACS) must fulfill hundreds of medical, bureaucratic, and organizational criteria. Just a few of them:

* An ACS-certified trauma center must care for a minimum of 1,200 trauma patients per year or admit at least 240 patients with a high “Injury Severity Score.”

* Its on-call trauma surgeon must be dedicated to a single trauma center while on duty.

* It must participate in regional disaster management plans and exercises.

* An emergency physician must be present in the department at all times.

 

Posted 6/28/2016

 

 
 
 
 

 

 

Search This Site:

Custom Search