Trauma in Marin – A System That Works
By James Hinsdale, MD
The case of two teen-aged Novato brothers critically injured in a December car crash is a rousing affirmation of how we in Marin are getting trauma care right.
The brothers were treated at the scene by a highly trained team of first responders, stabilized at Novato Community Hospital, then immediately transported to Marin General Hospital’s Level III Trauma Center. The younger brother later was transferred to Stanford Medical Center. According to a Website maintained by the brothers’ parents, the young men face a long rehabilitation but are gradually recovering.
They were taken to MGH because, even though other emergency medical facilities may have been closer to the crash scene, MGH’s Trauma Center has neurosurgical capabilities 24 hours a day. Both the severity of the injuries and the possibility of head trauma dictated transport to MGH. This case highlights the excellent trauma system that we in Marin are privileged to have.
Trauma centers such as the one that has existed at MGH since 2000 are expensive and complex to operate, and they are subject to political pressures, but they are absolutely essential to our community’s overall health.
Trauma systems offer great opportunities to save lives if three conditions are met: the system is well designed, the right personnel are assembled and work together, and participants at all levels are totally committed to improving quality of care.
Shortly after I arrived at MGH as Director of Trauma Services in July 2007, our team began to focus on achieving the holy grail of trauma care: full verification by the American College of Surgeons (ACS). In September 2009, ACS commended MGH for “its demonstrated commitment to
providing superior trauma care” and made it the first verified Level III trauma center in California.
This is a tremendous achievement for the entire MGH team, led by our head trauma nurse, Mary Jane Boyd, RN, and our Emergency Department director, Jim Dietz, MD. It’s also a reflection of the commitment of MGH management.
But designing a quality trauma center does no good unless the center is functioning within a system. In other words, the greatest surgeons and nurses may be standing by to stop the bleeding, but their talents will be squandered if the field responders can’t pick out the types of patients who need a trauma center and get them there quickly.
Fortunately, we in Marin have exemplary Emergency Medical Service leadership at the county level with EMS Administrator Miles Julihn and EMS Medical Director Bill Teufel, MD. They oversee the field responders of all kinds—fire, paramedics, EMTs, forestry officials and law enforcement—who are key to getting patients channeled to the trauma unit.
Despite Marin’s excellent trauma system, one critical component is missing – a helipad to transport seriously injured people to and from the hospital.
California Shock/Trauma Air Rescue (CALSTAR), which I serve as Medical Director, has just had its 25th anniversary. We have flown more than 30,000 patients with an unblemished safety record. Marin needs a helipad. It is embarrassing not to have one, given the capability of the trauma center and the quality of air transport care.
Finally, the governance at MGH is slated to change in late June, and Sutter Health’s management will cease. It is my sincere hope that the Marin Healthcare District leadership will continue the excellent care that we now provide to 1,000 trauma patients per year.
Do we think we have made a difference? Emphatically, yes. I have been proud to lead the trauma center for the past two and a half years and to collaborate with other dedicated MGH physicians and staff in achieving the prestigious ACS verification. We hope the citizens of Marin appreciate the level of trauma care available to them and continue to support the trauma system their community-wide medical leaders have designed and continue to maintain.
James Hinsdale, MD, a trauma surgeon with more than 30 years of experience and President-Elect of the California Medical Association, is Medical Director of Trauma Services at Marin General Hospital.
January 7, 2010