TAMC receives trauma patients, continues to strive for excellence in care

| February 17, 2012 | 0 Comments
Col. Michael Miller (center right), assistant chief, Emergency Department,  TAMC, performs an ultrasound on the right side of the SimMan 3G, patient simulator, while he leads a trauma care assessment during a mock simulated trauma activation in TAMC’s Emergency Room, Jan. 12.

Col. Michael Miller (center right), assistant chief, Emergency Department, TAMC, performs an ultrasound on the right side of the SimMan 3G, patient simulator, while he leads a trauma care assessment during a mock simulated trauma activation in TAMC’s Emergency Room, Jan. 12.

Story and Photo by
Stephanie Bryant
Tripler Army Medical Center Public Affairs

HONOLULU — Tripler Army Medical Center started receiving low-level trauma patients, here, recently.

Last year, TAMC treated 307 Department of Defense beneficiaries who were qualified to be trauma patients, so TAMC has been working to enter the State of Hawaii’s integrated trauma system.

“The driving force behind Tripler’s participation is their commitment to patient care,” said Navy Capt. Kenneth Kelly, chief, Emergency Department, TAMC.

Up until recently, Tripler did not have a systematic way of assessing trauma patients, according to Lt. Col. Kurt Edwards, chief, Trauma/Surgical Critical Care, TAMC.

Tripler does not have unused capacity to make additional treatment possible, but it does have unused skill.

“We have a certain amount of expertise, and if you were really to look on (Army Medicine), Tricare and Military Health System mission statements, their missions are to provide care and promote health of the military person,” Edwards said. “One of the biggest things that kills and injures our Soldiers is trauma.”

TAMC will become part of Hawaii’s Trauma Registry and can share trauma data.

“As a part of the Trauma Registry, we will share data and outcomes to improve the overall trauma system in Hawaii,” said Brig. Gen. Keith Gallagher, commander, Pacific Regional Medical Command and TAMC.

“We are honored to be part of this system and to help improve the trauma system and to share our experiences and insights gathered from multiple combat tours of our providers and nurses,” Gallagher added.

A hospital’s capability to care for trauma within the state is currently based on four-level systems, with level four being the lowest capability and level one being the highest.

“A State of Hawaii Level Three Trauma Center does not require instant presence of a trauma surgeon, anesthesiologist or operating theater personnel,” Edwards explained. “There are no requirements to have a sub-specialty, surgical services, other than orthopedics, available.

“The most likely reason to bypass a level three facility and proceed to a level two would be a person sustaining an injury severe enough to cause them to not be normally responsive,” Edwards added.

TAMC has prepared for its new trauma duties by training. Prior to Jan. 25, the hospital held multiple trauma assessment simulations using its simulation center’s SimMan 3G patient simulator.

Edwards said staff learned two valuable lessons from the mock activations: the physicians must be trained to answer radio calls from Emergency Medical Services and TAMC needed to create a system of group paging to notify trauma teams when a trauma patient is en route.

Edwards said, when it comes to trauma activations, everyone involved, no matter what the level, all play a vital role.

Before activating the trauma team, the physician must take the radio call from z first responders. Edwards said this action is important because it helps determine the facility the patient will actually be transported to.

As TAMC settles into its new role, the next step for the hospital is to expand its trauma personnel by hiring two additional trauma surgeons.

This requirement is not a condition to join Hawaii’s trauma system, but Tripler’s command wants to ensure it can provide excellent coverage for the hospital and its patrons prior to accepting civilian patients, explained Edwards.

Since Jan. 25, Tripler’s trauma program has responded to seven trauma activations.

“(Our goal is to ensure) that trauma care is better today than it was yesterday,” Edwards said.

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