Oregon's Level I Trauma Centers Celebrate 15th Anniversary
08/13/03 Portland, Ore.
Trauma cases increase this month
Trauma season is in full swing with more than a 30 percent increase in injuries in the last three months. Portland's two Level I trauma centers cared for close to 500 patients in July alone -- a good reminder of how many lives the trauma system affects. Since it started 15 years ago Oregon's pioneering trauma system has helped save lives every day. Without it April Mapes McVay and Jeff Zertanna might not be alive today.
April was in a tragic car crash in 1991 that ruptured her liver and spleen and lacerated her lungs. She was initially treated at Salem Hospital, then transferred to OHSU Hospital's Level I trauma center. Twelve years later she is happily married, embarking on a new career and has small scars but no lasting side effects. "I feel very fortunate," said April.
Jeff, a state champion dirt bike racer, crashed during a motocross event in April 2001. He suffered a broken femur, collapsed lungs and massive head trauma, and he remained in a coma at Legacy Emanuel Hospital for 55 days. Today, Jeff still can't recall the accident, but otherwise he suffers only short-term memory loss. "I've even been able to compete in motocross again," said Jeff.
Today trauma teams are saving more lives than ever before thanks to a 1985 state bill that authorized the development of the Oregon trauma system. The system was created in the spring of 1988 when the State Health Division designated Legacy Emanuel and Oregon Health & Science University as the only two Level I trauma centers in the state.
To maintain Level I status each hospital has to provide the highest level of comprehensive care for adults and children with very complex injuries. They must provide full-time services with a specially trained trauma team, dedicated operating rooms and intensive care units, and a commitment to caring for trauma patients. Other specialists such as neurosurgeons, plastic surgeons and orthopedic surgeons are on-call to respond to trauma needs immediately. In addition to direct patient care, Level I trauma centers are responsible for resident training, research, regional quality improvement, community education, outreach and injury prevention.
"It's exciting to have the opportunity to dramatically impact a person's life at the very beginning of their treatment. Many of our trauma patients are so young with so many years of life left to enjoy. We want to make sure they get the chance to enjoy it," said John Mayberry, M.D., interim chief of trauma and critical care at OHSU Hospital and associate professor of surgery in the OHSU School of Medicine. "April Mapes is a perfect example of how a good trauma system can work."
William Long, M.D., medical director of trauma services at Legacy adds, "Really, the Oregon trauma system is about more than just caring for the people of the city, the state and the region. Our system is looked upon as a model of trauma care for the entire country. It's truly a national asset."
Prior to the creation of Oregon's trauma program victims of trauma such as car crashes, farming accidents and gunshot wounds would be taken to the nearest emergency department. In many cases, these facilities didn't have the level of expertise on hand required to care for complex trauma cases. Now patients may still go to the nearest hospital, which may be in a rural community, but then they are transferred to the appropriate level of trauma center for advanced care. There are four levels of trauma care established by the Oregon Department of Human Services Trauma Program. OHSU and Emanuel are the state's only Level I centers.
An OHSU study of Oregon's trauma system in 1997 published in the Journal of the American Medical Association found that the trauma system reduced deaths by 30 percent.
The trauma programs are also celebrating the 25th anniversary of the Life Flight Network, an air ambulance service that serves northwest Oregon and southwest Washington. Each year flight crews transport more than 1,000 seriously ill or injured patients by helicopter, airplane or specialty ambulance. The network is operated by a consortium of Legacy Health System, OHSU and Providence Health System.
SPECIFICS ABOUT PATIENTS' STORIES:
April Mapes McVay of Salem was 21 when she lost control of her car and struck a tree. She was taken to Salem Hospital where emergency physicians stabilized her ruptured liver and spleen and she went through 30 quarts of blood. Then she was transferred to OHSU Hospital's trauma center and spent two months receiving intense critical care that's only available at Level I centers. Twelve years later, April is happily married, embarking on a new career in real estate and planning her 15-year McNary High School reunion. "I think about it [the accident] all the time," said April. "Other people are scared of hospitals, but not me. I remind them that hospitals are good places where people take good care of you."
Legacy Emanuel Hospital & Health Center
Jeff Zertanna of Hillsboro was 17 when he was thrown from his dirt bike at Portland International Raceway. He was taken to Emanuel Hospital with some of the most severe lung injuries doctors had ever seen. Jeff was put on ECMO, a system similar to a heart/lung bypass machine, and Emanuel became one of the few hospitals in the nation to use ECMO in an acute situation. Sadly, Jeff missed out on celebrating both his high school prom and his 18th birthday, as he was in the hospital for nearly five months. Now 20 years old, Jeff is in school, working and back to competing in motocross events. "We come by Emanuel periodically to visit with staff, show off Jeff's progress and thank them for the important work they do each day," said Sharon Zertanna, Jeff's mother. "We can't thank the trauma team enough for Jeff's survival."