pa trauma
Background
Motorists traveling on rural highways are severely or fatally injured at much higher rates than when traveling in urban areas. The Federal Highways Administration reports that 58% of motor vehicle fatalities (23,693 deaths) occurred on America’s rural highways in 1994, compared with 42% (16,983 deaths) on urban routes. In rural Central Pennsylvania, highway deaths are approximately 20 per 100,000 citizens, compared to the state average of 14 per 100,000 persons according to PennDoT estimates. Longer response times and delayed medical intervention due to remote, rural locations contribute to increased mortality and morbidity of crash victims.
Motor Vehicle Fatalities
Number of Deaths by Accident Location
Traumatized accident victims undergo a process of physical degradation that accelerates dramatically soon after the accident. Complications from loss of blood volume, insufficient oxygen supply and damage to key organs or the neurological system, plus the onset of shock increase appear quickly following the accident. |
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Alpha Community
Ambulance Service, Inc. |
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911 Emergency
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AT&T Wireless |
Geisinger |
Bureau of Highway Safety
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Pennsylvania Department of Health |
MedMedia, Inc. |
U.S. Wireless Corporation |
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The result is a quickly deteriorating health status that threatens life. This often occurs within a time period approximating one-hour. This "Golden Hour" is the window in which medical response must be administered to prevent mortality and minimize morbidity.
Emergency Response Times
Urban Versus Rural Fatal Crashes |
Vehicle crashes in rural and remote locations result in significantly longer response times for each step of the Emergency Response System compared to urban settings. Time for crash notification, time to arrive at the accident scene, and transport time to an emergency center total nearly one hour compared to one-half hour for emergency response in urban settings according to USDoT [1994 FARS and GES data files]. |
Accidents on the nation’s rural roadways present challenging circumstances for the emergency response system. However, the use of advanced communications technology and intelligent systems, when properly administered by trained personnel, promises improved emergency response through shorter response times and earlier medical trauma intervention.
Approach
The emergency response challenge in rural trauma consists of a series of problems: accident detection, notification, verification, response, transport and victim rescue/recovery, triage, and on-site medical intervention. Solutions to these challenges can categorically fall into a two part strategy: transportation logistics and telemedicine. The goal of an integrated effort to improve emergency response would be to achieve earlier victim intervention with more advanced medical care at-the-scene of rural accidents. The Geisinger Health System in cooperation with The Pennsylvania State University and The Pennsylvania Department of Transportation are partnered in the development of a model trauma care response system for the large rural region of northeastern, northcentral and central Pennsylvania. The system will test, evaluate and implement advanced telecommunications and telemedicine technology that will result in the improvements to the current EMS response and result in the reduction of trauma and death on the Commonwealth’s roadways. The results of this five year program will have nationwide applicability.
The essential program elements are: (1) advanced communications, information systems technology, vehicle positioning, navigation and intelligent command-control and logistics, and (2) accurate/detailed patient health status and monitoring coupled with telemedicine. During the course of this project, we will provide advanced communications, information and data linkages between the Level One Trauma Center in Danville and:
- nine hospitals geographically dispersed throughout rural Pennsylvania,
- select EMS and law enforcement units strategically located in the rural region.
- two medivac helicopter transport units in Bellefonte and Danville.
EMS training for the particulars of rural trauma response will be developed and administered following a needs analysis, curriculum development and administration of the course work using both hands-on teaching and tele-education with satellite downlinks.
Outcomes & Benefits
Overall EMS response to a vehicle crash and trauma victim(s) will be improved by:
- earlier medical intervention at-the-crash resulting from advanced communications, information and transportation logistics
- improved advanced medical treatment on-site through accurate and complete health status information telemetried between trauma care physician and emergency medical personnel.
The result will be a measurable improvement in safety, lives saved, recovery from trauma, and an important reduction of health care costs.
Presentations - PDF files (Acrobat Reader is required to read these files. Click here to download this free software)
Wireless Handheld Devices Assisting Emergency Medical Field Personnel - Years 1999-2001
Wireless Handheld Devices Assisting Emergency Medical Field Personnel - Years 2000-2001
Participating Entities
The Geisinger Health System in partnership with The Pennsylvania Transportation Institute and The Applied Research Laboratory of Penn State University are the principal parties in the conduct of this effort and will work in cooperation with The Pennsylvania Department of Transportation Office of Highway and Traffic Safety and The Pennsylvania Department of Health, bureau of Emergency Services.
