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A Geographical Analysis of Access to Trauma Centers from US National Parks in 2018

Published online by Cambridge University Press:  20 October 2022

Lily Y. Lu
Affiliation:
Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts USA
Sabrina N. Robichaud
Affiliation:
Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts USA Tufts University School of Medicine, Boston, Massachusetts USA
Krislyn M. Boggs
Affiliation:
Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts USA
Brandon R. Bedell
Affiliation:
Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts USA Boston University School of Medicine, Boston, Massachusetts USA
Rebecca E. Cash
Affiliation:
Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts USA
Ashley F. Sullivan
Affiliation:
Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts USA
N. Stuart Harris
Affiliation:
Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts USA
Carlos A. Camargo Jr.*
Affiliation:
Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts USA
*
Correspondence: Carlos A. Camargo, Jr., MD, DrPH Department of Emergency Medicine Massachusetts General Hospital 125 Nashua St, Suite 920 Boston, Massachusetts 02114-1101 USA E-mail: ccamargo@partners.org

Abstract

Introduction:

Millions of people visit US national parks annually to engage in recreational wilderness activities, which can occasionally result in traumatic injuries that require timely, high-level care. However, no study to date has specifically examined timely access to trauma centers from national parks. This study aimed to examine the accessibility of trauma care from national parks by calculating the travel time by ground and air from each park to its nearest trauma center. Using these calculations, the percentage of parks by census region with timely access to a trauma center was determined.

Methods:

This was a cross-sectional study analyzing travel times by ground and air transport between national parks and their closest adult advanced trauma center (ATC) in 2018. A list of parks was compiled from the National Parks Service (NPS) website, and the location of trauma centers from the 2018 National Emergency Department Inventory (NEDI)-USA database. Ground and air transport times were calculated using Google Maps and ArcGIS, with medians and interquartile ranges reported by US census region. Percentage of parks by region with timely trauma center access—defined as access within 60 minutes of travel time—were determined based on these calculated travel times.

Results:

In 2018, 83% of national parks had access to an adult ATC within 60 minutes of air travel, while only 26% had timely access by ground. Trauma center access varied by region, with median travel times highest in the West for both air and ground transport. At a national level, national parks were unequally distributed, with the West housing the most parks of all regions.

Conclusion:

While most national parks had timely access to a trauma center by air travel, significant gaps in access remain for ground, the extent of which varies greatly by region. To improve the accessibility of trauma center expertise from national parks, the study highlights the potential that increased implementation of trauma telehealth in emergency departments (EDs) may have in bridging these gaps.

Type
Original Research
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the World Association for Disaster and Emergency Medicine

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Footnotes

Note: Lily Y. Lu and Sabrina N. Robichaud should be considered joint first authors.

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