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Trauma training brings Canton-Potsdam Hospital one step closer to formal Level III Trauma Center designation

Posted 4/7/16

By MATT LINDSEY POTSDAM – Canton- Potsdam Hospital’s trauma training event held Thursday brings the hospital one step closer to a formal designation as the only Level III Trauma Center in St. …

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Trauma training brings Canton-Potsdam Hospital one step closer to formal Level III Trauma Center designation

Posted

By MATT LINDSEY

POTSDAM – Canton- Potsdam Hospital’s trauma training event held Thursday brings the hospital one step closer to a formal designation as the only Level III Trauma Center in St. Lawrence County.

When an accident happens and serious injuries have been sustained in St. Lawrence County, injured parties could be brought to CPH if the hospital obtains the formal designation.

The trauma team will be alerted and an estimated time of arrival along with details of the incident and person’s injuries will be shared with doctors and nurses, said Dr. Justin A. MacKinnon, director of the emergency department. X-ray and the phlebotomy departments are notified and ready as well.

“It is important for everyone to know their roles and be in position before the ambulance gets here,” he said.

The mock patient is one to two minutes out, according to an emergency medical technician (EMT) who is communicating hospital staff.

The "patient" in the case is a volunteer. Potsam EMT Christian Eggleston has volunteered to be the injured patients today and is wheeled into the emergency room where he is met with a team of nurses and a doctor.

Potsdam Volunteer EMT Jill Bellucci describes details of the patients’ injuries and status to Dr. MacKinnon.

“The patient is a 24-year-old male who swerved to avoid a deer,” Bellucci says. “He was driving about 55 mph.”

Dr. MacKinnon asks the patient about his pain levels and nurses cut of his clothes to examine for injuries, stab wounds and bullet holes that may be hidden in armpits, the legs, back and crotch areas.

“Where does it hurt?” he asks Eggleston. “What medications have you taken?”

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Dr. MacKinnon and a nurse work on the injured patient, Christian Eggleston. The nurse is cutting Eggleston's clothes off to check for injuries that may have been hidden. NorthCountryNow.com photo by Matt Lindsey.

While the doctor is conversing with the injured patient and assessing injuries, nurses are getting his vital signs.

“We need to be ready and keep things moving toward an assessment as the first few minutes are very important,” MacKinnon said. “Stabilizing the patient and looking for immediate life threats are priority.”

The trauma team practiced what to do when they receive a patient from EMS; following proper procedure for reporting; transferring of patient, and each person's role in the team. The training helped teach where each person is positioned; what the gatekeeper does; includes lab and x-ray (direction from charge nurse as to when they can enter the room following the doc's primary survey and secondary survey); practicing log-rolling, cervical immobilization, and more.

Canton-Potsdam Hospital is now able to handle injuries associated with car accidents, gunshots, and farms.

“In part because of the distances people in the North Country must travel, motor vehicle accidents account for most cases of trauma here,” she said.

Level III Trauma Centers may be held by a community hospital and addresses remote or isolated areas/modest-sized populations; level I centers are housed is an academic medical center/tertiary facility, Faber said.

“It may sound simple to know where to stand in the room, but it's a different protocol, and life-saving one, than for a visit to the ER for severe abdominal pain or dehydration, for example,” she said.

Approximately 60 to 75 percent of injured patients can be treated at CPH, depending on service capability and capacity, as long as that facility has trauma designation, said hospital spokesperson Rebecca Faber

“With this designation we are able to handle several levels of trauma and are able to more effectively and seamlessly transfer those who need Level II and Level I care,” Faber said. “It requires a close working relationship with a Trauma Level I Center, which we have in our long-standing affiliation with the University of Vermont Medical Center (formerly Fletcher Allen Health Care) of Burlington, Vermont.”

She says Level III Trauma designation allows more residents of St. Lawrence County to be cared for close to home.

“Level III trauma designation also balances the trauma patient load within a regional model, whereby moderately injured patients are cared for locally, allowing Level I facilities to focus their resources on more seriously injured patients, such as victims of deep-tissue burn injuries over most of the body's surface.”

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Dr. Jason Lorenc, who participated in the training event, has the volunteer patient squeeze his finger as part of the examination process of his injuries. NorthCountryNow.com photo by Matt Lindsey.

Canton-Potsdam Hospital became a Provisional Level III Trauma Center in March 2015.

St. Lawrence Health System conducted a feasibility study with input from their governing board and medical staff and then notified the New York State Bureau of EMS of the hospital's intent to proceed with trauma center designation, and at which level, Faber said.

Prior to provisional designation, the hospital worked toward achieving the bureau's guidelines and expectations, which included one full year of trauma registry data collection. That led to provisional designation, which gave them one year in which to submit a written progress report and updated timeline to meet American College of Surgeons verification, requesting a formal consultation from ACS and the Bureau.

“ACS verification preparation and visits happen within one year of provisional designation, at ACS discretion,” Faber said.

The hospital then must submit a formal application to the bureau for receipt of formal designation.

“In the meantime, to collect registry data and be fully prepared for the visit and formal designation, extensive real-time/real-case and simulation training must be ongoing,” she said.

Faber said part of the vital background to pursuing this designation was recruitment and retention of orthopedic surgeons and high-level specialties that complement the trauma team.

“We must have 24-hour orthopedic provider coverage; we have that now and are close to having gastroenterology and cardiology coverage too,” she said. “Training is part of what we do on an ongoing basis: all healthcare workers undergo some form of training continuously to keep up with medical/scientific breakthroughs and updates to the evidence base.

The training is part of our process toward a successful verification visit from ACS.

In order to satisfy the criteria, CPH must consistently demonstrate rapid response of lab and diagnostic results, blood bank response, provider services, as well as seamless coordination among all members of the levels, she said.

American College of Surgeons will make an investigatory visit later this year.