Trauma Therapist

Level 1 trauma centers in las vegas

UMC is home to Nevada’s first and only Level I Trauma Center and Designated Pediatric Trauma Center, verified by the American College of Surgeons and designated by the state.

Offering Nevada’s highest level of care, the UMC Trauma Center provides lifesaving treatment for community members, visitors and residents of surrounding states. Our service area consists of 10,000 square miles, including Southern Nevada, and parts of California, Utah and Arizona.

World-Class, Lifesaving Care

The UMC Trauma Center is a core component of Nevada’s emergency medical system. The facility and its world-class staff members provide 24-hour care, standing by to receive, stabilize and treat those whose lives are threatened by multi-system, brain and orthopedic injuries, and those at risk for multiple system organ failure. The UMC Trauma Center cares for more than 12,000 patients each year.

Always Prepared

The UMC Trauma Center always stands ready to provide Nevada’s highest level of care. As the ONLY free-standing trauma center west of the Mississippi River, the UMC Trauma Center offers three dedicated operating rooms for trauma patients, 11 resuscitation beds, and a fully staffed Trauma Intensive Care Unit with 18 beds. The UMC Trauma Center is staffed around the clock by expertly trained medical professionals who have dedicated their careers to saving lives.  

Las Vegas is not only a glittering strip of casinos and hotels but a fast-growing region with more than 2 million residents — and one hospital designated as a highest-level trauma center.

The deadly shooting Sunday that killed at least 59 and sent more than 500 people to area hospitals raised questions about whether that’s enough.

Las Vegas is not the only big city with just one such trauma center. Seattle and Nashville, among others, also are in this category, according to the American Trauma Society, a professional and advocacy organization focused on improving trauma care.

Casey Nolan, a hospital consultant and managing director of Navigant Consulting in Washington, D.C., said what matters most is not the number of high-level centers, but the degrees of coordination across the area’s medical network, including the first responders.

“It’s how well integrated the care is and whether there is a triage system to get patients to the right place in the right time,” he said.

What Makes Up The Network

The highest-level trauma centers are equipped and staffed around-the-clock to provide care for patients who suffer from traumatic injuries such as gunshot wounds, falls and car accidents.

The designation “trauma center” is the result of a validation process at the state or local level. Centers are categorized by Level I, II or III, for instance, in keeping with nationally accepted standards. Centers can also seek additional approval from the American College of Surgeons.

Across the country, there are 217 Level I trauma centers, up from 198 in 2012, according to the trauma society. These centers must see at least 1,200 trauma patients a year and have general surgeons and other specialists immediately available at the facility.

There are another 310 Level II centers that face similar staffing rules, but with fewer education and training requirements. Level III centers have emergency medical staff, but will stabilize severely injured patients and often transport them to higher-level trauma centers.

For decades, the hospital industry viewed trauma care as a money-losing proposition because of the high costs of keeping doctors and nurses on standby 24 hours a day. Trauma centers, particularly those in inner cities, tended to attract more patients without health insurance.

But in recent years, hospitals have been competing to get the designation as a way to increase profits, in part because trauma centers enhance demand for surgery and ancillary services like CT scans. In addition, a trauma designation can boost a facility’s overall reputation, Nolan added.

“Trauma had gotten a bad rap,” explained Nolan. “But in suburban locations, where more people have insurance, you can do pretty well on trauma.”

Some hospitals also began charging a fee — known as a “trauma activation” fee — to help pay for the extra staffing and equipment trauma units require.

Those fees could range from a few hundred dollars to several thousand dollars on patients’ bills, Nolan said.

Trauma Care In Las Vegas

Despite the burgeoning population of Las Vegas and surrounding Clark County, which more than doubled to 2.2 million in the past 25 years, University Medical Center has been Las Vegas’ only Level I trauma center since 1992.

The metro area includes two other lower-level trauma centers. Sunrise Hospital & Medical Center in Las Vegas is a Level II facility and St. Rose Dominican Hospital in nearby Henderson, Nev., is a Level III.

Even the idea of expanding Las Vegas’ trauma network has stirred controversy.

Last year, a state agency rejected applications by three hospitals in the Las Vegas area to be designated as Level III trauma centers.

HCA, the national, for-profit chain that owned two of these facilities, said adding trauma centers would help ensure quicker care to patients in the growing region. The company has made adding trauma centers a strategy across the country and has met resistance from existing centers.

But opponents argued HCA was motivated by the opportunity to boost profits. The Tampa Bay Times reported last year that the hospital chain charged significantly higher “activation fees” than other hospitals.

Opponents also countered that adding trauma centers would affect University Medical Center’s ability to provide quality care and train doctors. Some experts say it could diminish the number of patients seen at each center.

That’s because the more trauma patients a center deals with annually, the better the results, studies show.

“If you can bring all the patients to one place, then those surgeons become really good at dealing with trauma, instead of spreading it out [around a number of facilities],” said Bill Bullard, senior vice president with the Abaris Group, a California-based consulting firm that advises hospitals on emergency care.

Ian Weston, executive director of the American Trauma Society, said the trauma system worked well in Las Vegas, which is a credit to ambulances and other first responders and their ability to triage patients to hospitals across the city.

Seriously ill patients have the best outcomes when treated at a Level I trauma center, said David Callaway, a professor of emergency medicine at the Carolinas Medical Center in Charlotte, N.C. But “when you have 500-plus casualties and 58 dead … if all the patients went to a Level I, mortality would not be improved, because they would be completely overwhelmed,” Callaway added.

Bullard agreed.

“In theory, the more centers you have the more people you have to deal with injuries. However, no trauma system is able to handle a tragedy of this magnitude.”

LAS VEGAS (AP) — In a hallway just outside the doors of University Medical Center’s trauma center, the words “Wall of Hope” rest above photos of recovering former patients.

The pictures celebrate the patients’ accomplishments, and the hospital hopes displaying photos of people who’ve survived life-threatening injuries can offer a semblance of encouragement to current patients and their families.

“We want the family members to walk by here and say, ‘You know what? There is hope,’” UMC spokeswoman Danita Cohen said.

But the photos are also a nod to the work of UMC’s staff.

The wall provides just a snapshot of what the hospital’s trauma center does every day, Cohen said.

“The big thing here is we never know what’s going to come through the door,” said registered nurse Jim Foley, just a few hours into a 12-hour shift on May 27, the Friday of Memorial Day weekend.

UMC’s trauma center, the only Level 1 trauma center in Nevada, can treat the least and most severely injured trauma patients. It serves a 10,000-square-mile region covering parts of Arizona, California and Utah.

The trauma center has a 96 percent survival rate for patients who arrive alive within an hour of the traumatic incident.

Foley, who mixes humor and compassion when engaging with patients, often monitors the radio, which alerts the staff to new cases from the heartbreaking to the absurd.

“You feel for them,” he said. “Then some of the folks come in, and you think, ‘Dude, what were you thinking?’”

Lying on a bed near the rear of the trauma center, 36-year-old Dewayne Houston waited quietly to be discharged. Bandaging covered Houston’s thumb as Foley walked him through hospital paperwork.

When his finger got caught in a machine at the chocolate factory where he works, Houston was taken to a Henderson hospital, he said. When staff there couldn’t treat the wound, he was transported to UMC.

The tip of his thumb was cut off from the base of the nail and up. It couldn’t be reattached.

“It still hurts, just not as bad of course,” he said of the wound nearly two weeks later.

He complimented the care he received at UMC.

“They made me feel pretty nice,” he said.

Though UMC’s trauma center is generally busiest in the afternoon or evening, it takes only one bad moment for the quiet room to shift into a bustling crowd of nurses prepping patients, technicians performing tests and doctors overseeing the commotion.

“Everything is ready to go, right here,” said Dr. Dale Carrison, chief of staff and an emergency medicine physician.

Carrison, a towering figure with a careful gait and watchful eye, has been with UMC for about 25 years.

Carrison is known for his for his bedside manner, but his diverse background may be what helps him get along with a wide array of patients.

Medical director of Las Vegas Motor Speedway, chairman of the University of Nevada School of Medicine’s Department of Emergency Medicine and former FBI agent, he instantly strikes up a conversation with able patients — asking them about their lives, work and families.

Jeff Smith, 58, said he was driving near Losee Road and Cheyenne Avenue facing a green light when a truck ran a red light. He crashed into the side of the truck, and an ambulance that happened to be nearby drove him to UMC.

Smith arrived inside the trauma center on a gurney, alert, wearing a neck brace and feeling lucky.

“It could’ve been a lot worse,” he said.

He and Carrison chatted about the former Nevada Test Site as Carrison checked to ensure Smith’s medications for Parkinson’s disease didn’t conflict with what the hospital was giving him.

“It’s good to meet you,” Carrison told him. “I’m sorry we had to meet this way.”

When the physician later sat back down to peruse patient records, he was joined by Jocelyn Ochoa, a 20-year-old College of Southern Nevada nursing student.

Ochoa, the daughter of Carrison’s longtime housekeeper, said she sought the doctor’s advice after she decided to enter the medical field. He offered her a chance to learn firsthand by allowing her to shadow him at UMC.

“How he speaks to them is a miracle,” she said of Carrison’s relationship with patients.

Carrison insists it’s just part of the job.

“The hardest part is what they’re going through personally,” he said.

When a severely injured patient arrives, the trauma center breaks into organized chaos, Foley said.

It’s a point emphasized by Dr. Douglas Fraser, who made his way from the first-floor trauma unit to an upstairs conference room in the afternoon to quiz 15 medical students and residents on trauma care.

Fraser, a surgeon and the vice chief of the trauma department, is emphatic that UMC’s center is unique.

Trauma care at the Level 1 center requires multitasking and close teamwork for every case, he said.

“We’ve had nights where we have one after the next after the next,” he said.

Within a few hours of the class, he dealt with just that.

A helicopter landed swiftly and made way for another, and staff crowded around beds, awaiting the cases.

By then, patient volume had picked up. Seven of 11 trauma resuscitation beds were full.

Fraser calmly navigated a serious case, arms behind his back, marching alongside the bed as he encouragingly instructed staff.

Once that person was cared for, bloody sheets and equipment were tossed in the trash and staff members scattered to assist other patients.

Foley tried his best to make a nearby patient comfortable by telling jokes.

“I’ll close my eyes, you’ll close your eyes, we’ll see what happens,” he said with a needle in hand.

Behind a curtain, 45-year-old Scott Hill was also making people laugh, despite the blood on his face, the cut under his eye and the fact that the skin covering his nose appeared split in half.

Lindsay Wenger, the third-year general surgery resident stitching Hill’s nose back together, walked him through her work as it approached 7 p.m., the end of the workday for the first shift of trauma staff.

By then, Hill’s nose looked whole again. The bleeding didn’t stop him from telling his story of how an amateur mixed martial artist had caused the damage.

He said he was punched in the face, possibly with brass knuckles. He was found in a pool of blood at his home, and the Metropolitan Police Department responded to the scene.

“UMC, heck yeah,” Hill said within two weeks of leaving the hospital, after his stitches were removed. “I’m on their side. They were wonderful. I’ve had injuries in the past, but I’ve never had that kind of care.”

Fraser described trauma care as a team sport.

“We’re always prepared for your worst moment of your life,” he said. “That’s our average day.”

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Information from: Las Vegas Review-Journal, http://www.lvrj.com

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