New state rule may save lives for trauma patients and ISDH listening tour

INDIANAPOLIS—Hoosiers who suffer traumatic injuries are now more likely to be treated at verified trauma centers immediately following an injury, thanks to the adoption of the Triage and Transport Rule by the state’s Emergency Medical Services (EMS) Commission. The rule aims to better provide critical quality care during the first 60 minutes following a traumatic injury, known as the “golden hour” of care in emergency medicine.          

"In our efforts to create a statewide trauma system, this rule is foundational,” said State Health Commissioner Gregory Larkin, MD.  “It should mean more severely injured patients will be taken directly to trauma centers, and it should also mean more hospitals will become trauma centers." 

The rule advises that once EMS personnel have assessed the condition of each patient at the scene of an incident, they should then determine if the patient falls into the most severe categories of trauma injury as defined by the Centers for Disease Control and Prevention.  If so, the patient must be taken to the nearest trauma center.  The exceptions may include if transporting the patient would take more than 45 minutes, a patient’s right to decide or if the patient’s life will be endangered if care is delayed by going to the nearest trauma care center.  In these scenarios, the patient should be taken to the nearest appropriate hospital, as determined by the EMS provider protocols.

Traumatic injury is the number one killer of Hoosiers under the age of 45.

“Our number one priority is ensuring patients with traumatic injuries receive the lifesaving care they need, when they need it,” said Arthur L. Logsdon, director, Trauma and Injury Prevention at the Indiana State Department of Health. “Trauma centers utilize specific medical equipment and have skilled medical professionals available to handle the most severe, blunt force and puncture wounds. Trauma centers are proven to save the lives of those who have suffered the most devastating injuries. I am pleased the EMS Commission has voted positively on this rule.”

In fact, nationally, there is a 25 to 30 percent greater chance of survival when severely injured patients are taken to a trauma center versus an emergency room.

Trauma centers differ from hospital emergency rooms in some significant ways. Emergency departments are not trauma centers, as the typical emergency department treats broken legs, concussions, back sprains, lacerations, injuries resulting from motor vehicle rear-end crashes and trips on the sidewalk. Trauma center “typical patients” include those with multiple fractures, brain injuries, paralysis, punctured lungs, handgun and stab wounds, car rollovers and ejections or falls of more than 20 feet. They are verified by the American College of Surgeons.

Indiana has emergency medical services providers, trauma centers and a trauma registry to track these most severe of injuries, but is one of only nine states that do not have an integrated statewide trauma system.

Indiana has eight verified trauma centers:

• Deaconess Hospital, Evansville
• St. Mary’s Medical Center, Evansville
• Lutheran Hospital of Indiana, Fort Wayne
• Parkview Hospital, Fort Wayne
• IU Health Methodist Hospital, Indianapolis
• Wishard Memorial Hospital, Indianapolis
• IU Health Riley Hospital for Children, Indianapolis
• Memorial Hospital of South Bend, South Bend

In 2008, Senator Tom Wyss (R-Fort Wayne) authored Senate Enrolled Act 249 which tasked the EMS Commission with creating a rule to establish protocols for the transporting of trauma patients.

“I applaud the work of the EMS Commission and the state agencies involved in passing this rule,” said Senator Wyss.  “I wanted to make sure that Hoosiers were being taken to the proper destination after suffering a traumatic injury. This rule is one more step in the right direction toward patient safety and quality care.”

The Indiana State Department of Health’s Division of Trauma and Injury Prevention will conduct a Trauma Listening Tour this summer.  The goal is for Hoosiers to learn more about trauma, learn how state and local agencies currently respond to trauma, learn how an integrated trauma system could help the state and, most importantly, gather personal stories of how trauma has affected those in our state. To learn more about the Trauma Listening Tour, visitwww.StateHealth.in.gov.