Updates from Sierra Nevada Memorial Hospital | TheUnion.com

Updates from Sierra Nevada Memorial Hospital

Part two on trauma centers (part one appeared last Wednesday) answers why Dignity Health Sierra Nevada Memorial Hospital (SNMH) is not a trauma center. Designated by state or local government authorities or verified by the American College of Surgeons (ACS), trauma centers are assigned levels based on state specific guidelines. ACS also verifies trauma centers based on criteria set forth in the Resources for Optimal Care of the Injured Patient developed by their Committee on Trauma.

According to the American Hospital Directory, there are 344 acute care hospitals in California. Of those, 81 have trauma centers handling over 70,000 cases per year. Maintaining a trauma program is incredibly expensive and involves a series of criteria that many hospitals cannot meet. Even if a hospital applies to become a trauma center, it is not a hospital’s decision, but is made by the state or county based on need and coverage.

“Hospitals are required to maintain a certain volume of patients to preserve proficiency caring for trauma patients,” said Dr. Jeffrey Rosenburg, Chief Medical Officer of SNMH. “Unfortunately, SNMH does not have the patient population to meet that benchmark. Additionally, a hospital must have a dedicated operating room reserved only for trauma patients. Clinical teams must be present in the hospital 24/7, 365 days a year, and available to immediately treat trauma patients upon arrival. A full complement of surgical specialties, ICU intensivists, and ancillary staff must be available. The hospital must also keep supplies and equipment needed on hand.”

So how are our trauma cases managed? The sole focus is getting people to the level of care they need, even when it means circumventing SNMH. If there is a car accident on Highway 49 for example, first responders evaluate the victim’s condition and can choose to route that individual to the nearest trauma center. Both Dignity Health Mercy San Juan Medical Center and Sutter Roseville are designated as Level II trauma centers. The emergency transport knows to automatically transport all trauma patients to one of these two hospitals. If a trauma patient comes to SNMH’s emergency department, the clinical team makes the decision to transfer the patient. SNMH has a helipad which provides one method of transport down the hill, but the hospital’s ambulance is sometimes just as fast.

Criteria to become a Level I or II trauma center is extensive. They must admit at least 1,200 trauma patients annually or have 240 admissions with an Injury Severity Score of over 15. There is a long list of requirements. One example is orthopedics must be overseen by an individual who has completed a fellowship in orthopedic traumatology. Cardiothoracic surgery capabilities must be 24/7 and should have cardiopulmonary bypass equipment. A published trauma research program must also be in place.

While SNMH won’t likely become a trauma center, the staff wants the community to know the hospital provides excellent emergency and ongoing care and has a seamless process for getting patients to a higher level of trauma care if needed.

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