University of South Alabama

The Trauma Center at the University of South Alabama Medical Center is the first in south Alabama to earn Level I status, indicating the highest level of care.  A Level I center such as USA Medical Center provides a systematic response to trauma utilizing resources from all medical specialties to meet the special needs of the seriously injured patient at a moment's notice.  This organized approach greatly improves the patient’s chance for survival. 

Experience

Studies have shown that the more experience the staff has with high-risk surgical situations, the better the patient's chances are for survival.  The American College of Surgeons Committee on Trauma suggests that this level of experience can be obtained by treating 600-1,000 trauma patients each year.  The University of South Alabama Trauma Center admitted 1,650 patients during 2007 and nearly 1,800 patients in 2008. 

What Differentiates the USA Trauma Center From Other Hospitals:

  • Board-certified trauma surgeon in-house 24 hours a day.
  • A designated trauma team composed of a trauma surgeon, emergency physician, surgical residents, trauma nurse coordinator, trauma/emergency department nurses, radiologic technologist, respiratory therapists, and an anesthesiologist or nurse anesthetist.  This team responds to every trauma alert patient brought to the University of South Alabama Trauma Center.
  • Two dedicated shock-trauma beds in the emergency department.
  • An operating room staffed 24 hours a day to accommodate trauma cases.
  • A 16-bed Surgical/Trauma Intensive Care Unit staffed by specially trained nurses and with physician coverage in the unit 24 hours a day. 
  • Portable ultrasound dedicated to trauma services.
  • A trauma follow-up clinic where all trauma patients are assessed after discharge for referral to appropriate post-discharge treatment and rehabilitation, if needed.

Education

What is Trauma?

Trauma is accidental or intentional injuries that lead to life threatening situations.  Almost 80 percent of Alabama’s trauma cases are caused by motor vehicle crashes.  Other trauma cases involve falls, drowning, burns, assaults and poison ingestion.  Trauma is the leading cause of death among Americans under 44 years of age, killing more people than cancer, heart disease, AIDS or other diseases.
Every six minutes, someone in the United States either dies or is permanently disabled from trauma.  It affects one of every three people and at more than $400 billion annually is America's most costly health condition.

The Golden Hour

The “Golden Hour” is the first 60 minutes after an injury in which the lives of a majority of critically injured trauma patients can be saved if definitive surgical intervention is provided.  This golden hour begins at the moment of injury, and includes notification of police/fire-rescue/EMS, providing initial stabilization at the scene of the accident and transport to a trauma center, where appropriate medical staff can perform the necessary life saving interventions

The Trauma System

To improve the odds of survival for trauma victims, the state of Alabama has developed a regionalized trauma system.  Trauma systems improve survival rates by enhancing the efficiency of health care delivery.  By utilizing protocols and algorithms, patients are assured of appropriate care within the “golden hour.”
Components of the Alabama Trauma System are: EMS, or emergency medical services personnel (ground and air), 911 and trauma communications centers, and a network of participating hospitals designated as trauma centers.  While 911 centers dispatch the necessary resources to respond to the scene of an accident, trauma communications centers route EMS crews to appropriate trauma centers based on the patient’s specific injuries and the location of the accident.

Trauma Centers

Trauma Centers such as USA Medical Center are hospitals with a commitment to treat trauma patients.  However, establishing a trauma center can be extremely costly, as it requires dedicated surgeons and support personnel, along with necessary technologies and facilities.  For this reason, only a handful of hospitals serve as trauma centers.

The Alabama Department of Public Health conducts an inventory of hospitals participating in the trauma system to determine their level of capability.  

Level I - These facilities are regional centers which have the capability of providing leadership and total care for every aspect of injury, from prevention through rehabilitation. These centers offer comprehensive care, including advanced surgical care.  USA Medical Center is the only Level I Trauma Center in southwest Alabama.

Level II - These facilities are expected to provide initial definitive trauma care regardless of severity of injury. Patients with more complex injuries may have to be transferred to a Level I center.

Level III - These facilities provide prompt assessment, resuscitation, emergency operations, and stabilization. They also arrange for possible transfer to a Level I or Level II facility that can provide definitive trauma care.  Level III facilities serve areas that do not have immediate access to a Level I or Level II facility.

Admissions and Referrals

Hospitals within the USA Trauma Center region (southeastern Mississippi, southern Alabama, Florida panhandle) may already be participating in an Automatic Acceptance agreement.  The Automatic Acceptance agreements reduce the amount of time it takes to transfer a patient to the USA Trauma Center by eliminating the standard referral process. 

Referring physicians simply call the USA Medical Center Emergency Department to give a report of the patient transfer and estimated time of the patient’s arrival.  This process facilitates a patient’s entry into the trauma system within the golden hour confinements, which improves the chances for favorable outcomes. 

If you are uncertain whether your facility has an Automatic Acceptance agreement with the University of South Alabama Trauma Center, contact your hospital administrator or emergency department medical director.  

If your facility does not have an Automatic Acceptance agreement, or if you are uncertain, you may call the USA Physicians Referral Line at 800-388-8721.

Center for the Study of Rural Vehicular Trauma

The University of South Alabama Center for the Study of Rural Vehicular Trauma is funded through a cooperative agreement with the U.S. Department of Transportation/National Highway Traffic Safety Administration.  The Center’s two main objectives are to identify why the majority of fatalities from motor vehicle accidents occur in the rural setting (though the majority of accidents occur in the urban setting) and to develop measures to reduce these numbers.

Utilizing specialized CODES software developed by the U.S. Department of Transportation, the Center joined more than 38,000 police crash reports with emergency medical services (EMS) patient care reports.  Joining data from two different sources provides a clearer and more comprehensive picture of the crash event.

Analysis of the joined records shows several important performance standards for rural EMS providers correlate (not cause) directly with higher mortality rates:
  • Response time (time to get to the scene of the accident),
  • Response distance (distance from EMS starting point to reaching the scene of the accident),
  • Scene time (amount of time spent at the scene of the accident before beginning transport) and,
  • Two critical skills provided by EMS personnel (placement of Intravenous [IV] Lines, and endotracheal intubation [breathing tube]) were all statistically associated with mortality rates  http://www-nrd.nhtsa.dot.gov/departments/nrd-01/summaries/4313FA.html
From this discovery, the USA Center for the Study of Rural Vehicular Trauma developed a number of projects aimed at reducing time and distance components associated with rural vehicular fatalities.  Most projects are complete and the Center's staff is developing corresponding reports for publication in appropriate medical journals.
 

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