Trauma is a word that may evoke some mental drama. But in health care lingo, it means someone got injured – often severely, and they need emergency care to save their life, save a limb, or prevent serious complications.
When it happens in a rural location, a small critical access hospital is often the patient’s first destination.
As in cities, motor vehicle crashes are a major cause of trauma. In rural areas, there are also ATV rollovers, farm accidents, horseback and large animal injuries, and even the occasional bus accident.
“Most trauma is at 2 a.m., not 2 p.m.,” said Tami Schnetter BSN, RN, TCRN, Trauma Program Manager at Avera McKennan Hospital & University Health Center. She and Michael Person, MD, Medical Director for Avera McKennan Trauma Service, offer the Rural Trauma Team Development Course in hospitals across the Avera footprint.
“Patients experience the best outcomes when they receive best-practice treatment as quickly as possible,” Person said.
Distance is the first barrier, the accident may have happened 80 miles away from the hospital. “So emergency medical services are an important partner in the outcome of an injured patient,” Schnetter said.
Rural Trauma Team Development Course
Through state funding, the Rural Trauma Team Development Course (RTTDC™) is offered by Avera and other health care partners at various locations throughout the year. The course helps hospitals:
- Organize a rural trauma team with defined roles and responsibilities for all team members
- Prepare a rural facility for the appropriate care of the injured patient
- Identify local resources and limitations
- Assess and resuscitate a trauma patient and initiate the transfer process early
- Establish a performance improvement process to ensure care is done the same way every time
- Encourage effective communication
- Define the relationship between the rural trauma facility and the regional trauma system
The rural trauma course helps local emergency room staff ensure they are prepared with the right equipment and the right protocols, said Schnetter. “We go into their facility, come up with mock scenarios, and then ask questions, for instance, “where are your breathing tubes to establish an airway?”
“We’re not there to tell them how they should do things, but rather to present best practices guidelines and help them narrow down their care interventions to the same protocol, so everyone is doing it the same way,” Schnetter said. “Rural centers are not confronted with a serious trauma case every day, so this helps remove some of the isolation or angst they might feel.”
Support for Rural ER Teams
Avera emergency rooms are supported by telemedicine through an immediate audio/video connection with emergency specialists.
If the patient needs a higher level of care, the local team works to arrange a transfer either via ground ambulance or an airflight. But in the meantime, the local team must ensure the patient is stabilized and ready to safely travel.
Strong attendance at the courses underlines the importance of this training. “We’ve been to some of the smallest hospitals in the state and will have 30 people show up – physicians, advanced practice providers, nurses, EMS personnel, lab, radiology and even chaplains and administrators,” Schnetter said.
Avera’s rural footprint fosters innovation. “Avera has collaborated over the years to develop a strong network of hospitals and programs like air transport and telemedicine that support rural health,” Person said. “But at the crucial moment when a trauma case presents in a rural emergency room, the local team is that person’s lifeline. This training helps to support them, alongside the other resources Avera offers through the strength of its system.”
Learn about emergency services at Avera.
