Grand Strand Regional Medical Center will begin offering services equivalent to those provided at Level II trauma centers on November 1 as the first step in seeking designation by the American College of Surgeons (ACS) and DHEC as a Level II trauma center. A one year verification period is required prior to ACS officials reviewing all aspects of the program, including staffing, protocols and patient outcomes. The hospital currently is a Level III center.
Hospital officials announced in October 2009 their intention to seek Level II status. The only other nearby Level II centers are in Anderson, SC, and Wilmington, NC. Level I trauma centers are in Charleston, Columbia, Greenville and Spartanburg, SC.
“A trauma patient is someone who has suffered serious and life-threatening physical injury with the potential for secondary complications such as shock, respiratory failure or even death, something that could happen to any one of us or our loved ones at any time,” explained John Molnar, MD, emergency department medical director, “In many cases, the difference between life and death following a trauma is time.”
It is well established that the victim’s chances of survival are greatest if care is received within a short period of time after a severe injury. In a life-threatening accident, the chance of survival increases dramatically if there is a designated trauma program close to the victim.
Officials have spent the past year recruiting staff, writing protocols, meeting with EMS and reviewing the many standards and requirements of Level II.
“A major part of the process has been the recruitment of trauma surgeons, a trauma orthopedic surgeon and additional nursing staff,” said Lewis Dickinson, MD, medical director of the trauma service. “Trauma center designation criteria set strict requirements for staffing, specialist availability, response times, training, quality improvement and community education.”
A Level II trauma center must have an operating room and surgery staff available 24/7. In addition, a trauma surgeon and anesthesia staff must be in the hospital 24 hours every day, with major surgical specialties, including general surgeons, orthopedic surgeons, neurosurgeons and anesthesia staff on-call, but clearly committed to being in the emergency department when the patient arrives. Two designated trauma nurses must be available in the emergency department at all times.
The Grand Strand Regional trauma program currently has four trauma surgeons and one orthopedic trauma surgeon along with a complement of anesthesia staff, nurses and ancillary staff. All critical care, surgical and emergency department nurses have completed trauma nursing core certification in addition to the required advanced cardiac life support and pediatric advanced life support training.
In recent months, hospital staff has worked closely with local emergency medical service providers for training and protocols and will continue with training and education.
“Care of the trauma patient begins in the field with EMS and continues until the patient is discharged,” said Dr. Dickinson. “All areas of the hospital – from critical care and surgery to laboratory, nutrition and physical therapy – are involved throughout the continuum of care.”
Quality improvement and outcomes are a vital part of the trauma process and a trauma registrar will enter all trauma patients into a state and national database to continuously track trends and monitor quality improvement.
“Grand Strand Regional is well positioned to become a Level II designated trauma center and we are pleased to bring this higher level of care to our region,” said Doug White, chief executive officer. “This new service will be a tremendous benefit to this part of South Carolina and is not possible without the commitment and dedication of hospital staff, physicians and EMS responders.”
The designation process includes verification of compliance standards by the American College of Surgeons (ACS) and the South Carolina Department of Health and Environmental Control (DHEC), Division of EMS and Trauma.