Behind the scenes at TMC Trauma

August 19, 2009 8:57:54 PM PDT
Houston is home to the busiest trauma center in the country, and some doctors say with all the patients, it is tough to keep up and it is costing lives.Doctors and nurses in Houston's Memorial Hermann Texas Medical Center have seen an added strain of more patients following Hurricane Ike. Even with UTMB Galveston reopening, it's not letting up.

In a region with 5 million people, this is the only place like it.

"The report lists a heart beat, but I don't see it measured anywhere," said Dr. James McCarthy, Emergency Medical Director. "At any given time we have the capacity to take care of any degree of injury."

Memorial Hermann Texas Medical Center is a level one trauma facility. It's a place where people on the brink of death come to live.

"There are not too many physicians who are crazy enough to want to fool with this stuff," said Dr. James "Red" Duke, Life Flight Medical Director.

And it is the busiest trauma center in the nation.

"The average level one trauma center does about 1,000 admissions a year. We're doing 6,000," said Dr. McCarthy.

Often times, there are too many patients with too few beds to hold them.

"Everything jumped after Ike last fall, but we were already on a collision course for a problem before that," Dr. McCarthy said.

What makes the Medical Center so unique is not only its expertise, but its wings. Memorial Hermann is the only trauma center with a helipad.

"Depending on which way the wind is blowing and where the pilot chooses to land, the scene may actually be behind us," said Sam Miller, Life Flight Paramedic.

It is home to Life Flight, a program started 33 years by Dr. Red Duke.

"We made three flights the first day and 45 the first month and it just kept going," said Dr. Duke.

It keeps going, with helicopters and paramedics placed all over the region, dispatched when time is critical.

"Until we get there and actually put hands on the patient we really don't have any idea," said Josh McCormack, Life Flight Paramedic. "There's going to be at least two helicopters on scene. Us and another helicopter."

From the time the call came in, Life Flight was all the way from the Medical Center to here on Fry Road in just a matter of two minutes or so. There are two seriously injured patients. One has multiple injuries that are critical and he needs to be transported immediately.

Another ten minutes, and the patient is in the Emergency Room.

"He has several life threatening injuries here. He's considered critical at this time," said Miller.

In the room next to him is fifth grader Michael Gann.

"It's just a miracle that he survived, just a miracle," said Michael's father.

He was flown from Baytown after flipping an ATV and getting trapped underneath it.

"He's gonna be OK. We're waiting to go to surgery. He fractured his femur. They've got a lot of traumas in the OR right now so as soon as they can get him in they will," said Michael's mother.

That is the problem - this trauma center is too popular. Nearly 20 percent of the time it is on diversion, meaning it cannot accept more patients. Yet they still come. Like this man who was transferred from a hospital an hour away by air.

"We get them from everywhere. Every day. It's just the way it is," said Dr. McCarthy.

We saw it again and again.

"There's the transfer center calling me right now wanting to transfer a patient. Excuse me one second," said Dr. Neel Ware, a trauma surgeon.

As we talked to Dr. Ware about the challenges of taking in patients that other area hospitals cannot or will not treat, he was interrupted by another transfer request.

"OK, a twenty-year-old male stabbed in the wrist. He's got a radial artery injury in Bay City," said Dr. Ware.

The ER here is on diversion more than four times what is acceptable for the best care. It's a function the doctors here say of too few hospitals offering traumatic care at a high level.

When asked if patients die here because there isn't enough service, Dr. McCarthy answers, "Sure. Yeah. Absolutely."

There is no end in sight, not even with the addition of UTMB Galveston as a level one trauma facility. The doctors and nurses here say it will only get worse.

"The city is getting progressively bigger but trauma capacity hasn't expanded in this city for a decade or more, actually," said Dr. McCarthy.

And there won't be until some other hospital steps up to share the load.

"We certainly ought to have more to meet the need," said Dr. Duke.

Until that time, the busiest trauma center in the nation will likely stay that way. For better and for the worst.

Medical industry analysts suggest that metropolitan areas need one level one trauma center for every one million residents. Southeast Texas, home to 5 million people, has two, not including UTMB Galveston.

As for UTMB, the emergency room has been back open for a little more than two weeks. It had been closed after Hurricane Ike last year. Doctors at UTMB say they're operating like a level one trauma center, as before the storm, but they have not yet received that designation. They're working to regain it.

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