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A Decentralized Trauma System Design for a Rural Area

Published online by Cambridge University Press:  28 June 2012

Richard A. Narad*
Affiliation:
Department of Health and Community Services, California State University-Chico, Chico, California, USA
Jack L. Becker
Affiliation:
Department of Health and Community Services, California State University-Chico, Chico, California, USA
Christy Frecceri
Affiliation:
Department of Health and Community Services, California State University-Chico, Chico, California, USA
*
Department of Health and Community Services, California State University-Chico, Chico, CA 95929-0505USA; e-mail:rnarad@oavax.csuchico.edu

Abstract

Most trauma-care systems are based on an urban model in which patients are found in sufficient proximity to the trauma center to allow preferential triage. The roles of other hospitals in the community are limited. In rural areas, patients may be remote from the trauma center and may require initial stabilization at a closer, nontrauma “center” designated hospital. An inclusive trauma system design is more appropriate in such situations.

The Emergency Department Approved for Trauma (EDAT) is a program implemented in a rural area of northeastern California that establishes minimum standards for non-trauma center designated hospitals in remote areas. It integrates these hospitals into the trauma system through transfer guidelines and agreements and participation in systemwide quality assurance/improvement programs. The EDAT program promotes both improved initial treatment of rural trauma patients and appropriate transfer of patients to designated trauma centers.

Type
Special Report
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1996

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References

1. Department of Health and Human Services (DHHS): Model Trauma Care System Plan (Draft—30 September 1992). Washington, DC: USDHHS, 1990, pp 12.Google Scholar
2. Bazzoli, GJ, Madura, KJ, Cooper, Gf, et al. : Progress in the development of trauma systems in the United States. JAMA 1995;273:395401.CrossRefGoogle ScholarPubMed
3. Waller, JA, Curran, R, Noyes, F: Traffic deaths: A preliminary study of urban and rural fatalities. California Medicine 1964;101:272276i.Google Scholar
4. Office of Technology Assessment: Rural Emergency Medical Services. Washington, D.C.: U.S. Government Printing Office, 1989, p 18.Google Scholar
5. Office of Technology Assessment: Rural Emergency Medical Services. Washington, D.C.: U.S. Government Printing Office, 1989, p 4.Google Scholar
6. Baker, SP, O'Neill, B, Karpf, R: The Injury Fact Book. Lexington, Mass.: Lexington Books, 1984, p 313, in Committee on Trauma Research, Commission on Life Sciences, National Research Council, and the Institute of Medicine: Injury in America. Washington, D.C.: National Academy Press, 1985, p 26.Google Scholar
7. Gilmore, KM, Clemmer, TP, Orme, JF: Commitment to trauma in a low population density area. J Trauma 1981;21:883886.CrossRefGoogle Scholar
8. California EMS Authority: California Rural EMS Study. March 1992, p 36.Google Scholar
9. Office of Technology Assessment: Rural Emergency Medical Services. Washington, D.C.: U.S. Government Printing Office, 1989, p 41.Google Scholar
10. Fallon, MJ, Copass, M: Southeast Alaska to Seattle emergency medical air transports: Demographics, stabilization, and outcomes. Ann Emerg Med 1990;19:914920.CrossRefGoogle ScholarPubMed
11. Certo, TF, Rogers, FB, Pilcher, DB: Review of care of fatally injured patients in a rural state: Five-year followup. J Trauma 1983;23:559565.CrossRefGoogle Scholar
12. Office of Technology Assessment: Rural Emergency Medical Services. Washington, D.C.: U.S. Government Printing Office, 1989, pp23.Google Scholar
13. Rinker, CF, Sabo, RR: Operative management of rural trauma over a 10-year period. Amer J Surg 1989;158:548551.CrossRefGoogle ScholarPubMed
14. Martin, GD, Cogbill, TH, Landercasper, J, Strutt, PJ: Prospective analysis of rural interhospital transfer of injured patients to a referral trauma center. J Trauma 1990;30:10171018.CrossRefGoogle ScholarPubMed
15. Tortella, BJ, Trunkey, DD: Hospital care. In: Cales, RH, Heilig, RW Trauma Care Systems, (eds.) Rockville, Md.: Aspen Publishers Inc., 1986, pp 150151.Google Scholar
16. American College of Surgeons, Committee on Trauma: Resources for optimal care of the injured patient. Chicago: American College of Surgeons, 1993, p 3.Google Scholar
17. American College of Emergency Physicians: Guidelines for trauma care systems. Ann Emerg Med 1987;16:459463.CrossRefGoogle Scholar
18. General Accounting Office: States Assume Leadership Role in Providing Emergency Medical Services. Washington, D.C.: General Accounting Office. 1986, pp 5253.Google Scholar
19. Committee on Trauma Research, Commission on Life Sciences, National Research Council, and the Institute of Medicine: Injury in America. Washington, D.C.: National Academy Press, 1985, p 66.Google Scholar
20. American College of Surgeons, Committee on Trauma: Resources for optimal care of the injured patient. Chicago: American College of Surgeons, 1993, p 67.Google Scholar
21. California Health and Safety Code, Section 1796.160 et seq.Google Scholar
22. National Highway Traffic Safety Administration: Trauma System Development (DOT HS 807 257, Final Report). 1988, p 98.Google Scholar
23. California Code of Regulations, Title 22, Section 100255.Google Scholar
24. Seidel, JS: A needs assessment of advanced life support and emergency medical services in the pediatric patient: State of the art. Circulation 1986;74:IV12933.Google ScholarPubMed
25. California Health and Safety Code, Section 1798.165(c).Google Scholar
26. Northern California EMS Inc.: Nor-Cal EMS/Greater Butte County Trauma Care System Plan. 1987, p III11.Google Scholar
27. Northern California EMS Inc.: Nor-Cal EMS/North Zone Trauma Care System Plan. 1989, p III9.Google Scholar
26. Northern California EMS Inc.: North Zone Trauma Request for Proposals. 1989, p 42.Google Scholar