State Capitol Week in Review

From Senator Larry Teague

November 29, 2019

LITTLE ROCK – The legislature created the Arkansas Trauma System 10 years ago, with passage of Act 393 of 2009.

The trauma system directs emergency responders to the closest hospital that provides the care needed by the trauma victim. That is not always the closest hospital.

It’s possible that an ambulance carrying a severely injured person would need to bypass a level four facility, in order to more quickly arrive at a level one facility that can immediately treat the trauma.

There are 62 facilities in the system. Six are level one, four are level two, 18 are level three and 34 are level four.

The six level one systems can handle the most severe trauma cases. Two are in Little Rock, two are in Memphis and two are in Springfield, Missouri. The level two hospitals are in Little Rock, Springfield, Hot Springs and Fayetteville.

The levels do not indicate the quality of care provided by the hospital. It indicates the resources available, for example, whether or not they have a neurologist on call.

Establishing the trauma system involved much more than coordinating emergency response teams with the closest hospital that offers appropriate care. The system has distributed grants to hospitals and firms that provide emergency medical services. More than 7,000 nurses have been trained in trauma care over the past 10 years.

For anyone who has suffered a traumatic injury, the system has possibly saved their life. Studies indicate that the Arkansas trauma system has lowered the mortality rate for traumatic injuries in Arkansas by 50 percent since 2009.

In many cases the system has made care more accessible and convenient for victims and their families. For example, since 2009 the trauma system has evaluated 3,565 burn cases, and one percent of the victims are now transferred out of state for further treatment. Ten years ago 12 percent of burn victims needed to be transferred out of state.

Hospitals and public health agencies maintain extremely complex medical records, such as images of X-rays and ultrasounds. The trauma image repository can send images to a facility, before the arrival of the patient, to eliminate the need for duplicate testing and to speed treatment.

Arkansas was one of the last states in the country to set up a statewide trauma system, but it’s now the first and only state to operate an ongoing “preventable mortality review.” More than 820 trauma cases have been closely reviewed, with the goal of improving care by streamlining protocols practiced by health care providers, and requiring that trauma care guidelines be more rigorous.

The trauma system has purchased 611 radios that operate under the Arkansas Wireless Information Network. The radios allow ambulances to stay in communication with emergency rooms in areas where there is no cell phone service, and in periods when cell service is down. This is vitally important should a natural disaster occur, or an event that affects massive numbers of people in a large area.

The Arkansas Trauma System is operated out of the state Health Department. On a regular basis it reports to the Senate Committee on Public Health, Welfare and Labor.