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We Need Trauma Centers
Due to the advanced state of industry a number of devices and machines have come into common use which, often through intentional misuse, result in very serious injuries. Two examples are the automobile and the gun. When a serious injury results from something such as an automobile accident the victim usually has a very short period in which to obtain emergency medical intervention before the shock resulting from his or her injuries is irreversible. Usually this period of time is not longer than one hour, and is often less. If measures to treat shock and the cause of the shock, massive internal bleeding for instance, are not instituted within this first hour after the injury the mortality rate increases exponentially every fifteen to twenty minutes.
The state of emergency medical care currently practiced in this community involves an excellent pre-hospital phase under the jurisdiction of Los Angeles City paramedics. The paramedics have jurisdiction of about thirty-five emergency rooms to which their patients can be transferred after beginning medical treatment at the scene of the accident. This is where the problem occurs. To provide the best possible emergency care at the hospital, two factors play an important part. First, the staff must work on at least two to three severely injured patients daily to maintain their technical skill at top level. Second, surgeons and operating rooms must be available within 15 minutes notice, twenty-four hours a day, 365 days a year. In the San Fernando Valley, this level of care is not met anywhere. In greater Los Angeles, this level of care is met at less than six hospitals. The problem involves too many emergency rooms for the population. The cost of maintaining an operating room on fifteen minute standby day and night would put hospitals out of business, since even the busiest hospitals only receive three to four severely injured patients each week. The patient load would not support the very high cost of this service.
The best remedy to this situation would be to designate "Trauma Centers". Instead of having thirty five emergency rooms taking care of the critically injured patients three or four selected emergency rooms would be geographically designated to receive all of the critical patients.
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