Trauma System Saved My Life.......I was not expected to live after a fall of 30 feet and I am alive!

The following story is just one article done about the trauma system that saved my life. I am alive today because of a trauma system that got me to a level 1 trauma hospital and after three months in

The following story is just one article done about the trauma system that saved my life. I am alive today because of a trauma system that got me to a level 1 trauma hospital and after three months in the hospital of which the first four weeks I remained unconscious I have re-learned to walk, talk, write, eat, speak and other bodily functions. I credit this miraculous recovery to divine intervention, tons of prayer, and a trauma medical system that saved my life. As they began my 17 hours of surgery my wife was told that "If your husband lives through the next 2 hours he will most likey be in a wheelchair and on life support for the rest of his life!" I have beat all odds and while still in rehab returned to an almost normal life. My mission now in life is to offer encouragement, hope, and love to others that have been through a traumatic experience. I am trying to raise awareness through publications, e-mails and presentations that we need to increase budgets statewide for truama training and equipment to save others lives. If anyone reading this knows of one person who can use a phone call or help in anyway please contact me through my e-mail.

I have a video that I can send a link to anyone showing the re-enactment of my accident if interested...........

God Bless,

Rod

rod(at)wavewls.com please use @ between my name and wavewls.com

Trauma Systems Save Rural Lives

by Candi Helseth

 

 

In March 2006, Rod Landrum fell 30 feet off the barn on his farm near Parsons, Kan. Today Landrum is a walking advertisement for the Kansas trauma system, implemented statewide in 2001, which Landrum credits for saving his life.

"I had more bones broken than not on my right side," Landrum said. "For four weeks I never knew what was going on because I was unconscious. I would not be alive today if it weren't for the trauma team. The system worked perfectly."

"They did all the right things," he added, "starting with our local EMS department that had the vision to get trauma training and got to my farm within three or four minutes, then on to our local hospital a couple miles down the road that stabilized me, and on to the helicopter system that airlifted me to the trauma center and the skilled professionals who cared for me the three months I was hospitalized." His injuries included a broken neck, hip, back and knee, broken arms, wrists and facial bones, and some brain trauma.

Landrum, who is back at work full-time, spent months learning to speak, write and walk again. He is one of the fortunate ones. People living in rural areas are less likely to survive major traumas, which contribute to the sudden, unexpected deaths of an estimated 160,000 Americans each year, according to a national assessment survey by the Health Resources and Services Administration (HRSA). Trauma is the leading cause of death for Americans 35 and younger, and permanently disables 80,000 Americans every year. Often referred to as the neglected disease of the 21st century, trauma encompasses a variety of conditions attributed to injuries, accidents and violence.

Nearly 60 percent of all trauma deaths occur in rural areas where only 20 percent of the nation's population lives. Optimal care can be compromised by a variety of factors, including long distances to medical facilities, weather conditions, poorly maintained roads and other geographic factors. Additionally, many small rural facilities lack resources and have little experience caring for trauma patients due to low volumes and lack of trauma training.

Organized trauma care systems are critical to reducing mortality and morbidity rates in rural America, according to Dr. Nels Sanddal, president of the Critical Illness and Trauma Foundation. "What we can say with confidence from pre- and post-trauma system preventable mortality studies is that a trauma system results in fewer unnecessary deaths. It is the organization, integration and appropriate utilization of existing resources that makes a difference, even in rural and frontier areas where those resources may be very limited."

In Washington, where a statewide system was fully implemented and funded in 1995, trauma was the fifth leading cause of death for all ages and the cause of 75 percent of deaths for ages 15-24. From 1995 to 2006, the number of patients surviving major trauma incidents increased from 75 to 86.5 percent.

"That means an additional 2,000 lives were potentially saved if the 1995 case fatality rate had remained the same," said Washington State Trauma Plan Section Manager Kathy Schmitt.

Access to Trauma Care Varies by State

But access to a coordinated trauma care system varies widely across the nation. Only 24 percent of rural residents have one-hour access to Level I or II trauma centers, compared to 86.2 percent of suburban residents and 95.3 percent of urban residents, said Charles C. Branas, a University of Pennsylvania professor who has conducted extensive trauma research. Trauma centers are listed in classes, with Level I and II centers providing the most comprehensive care for critically injured patients and Level III-V centers providing emergency care. The American College of Surgeons verifies Level I-III trauma center status. Level IV and V status is designated by the states.

Branas said about 46.7 million people do not have access to a trauma center within what is known as the Golden Hour, the first 60 minutes after an injury when trauma care is most effective in saving lives. Landrum arrived at a Level I trauma center 54 minutes after his fall. Trauma system advocates say that trauma centers must be supported by coordinated trauma care systems, particularly in rural areas where distance already works against speed.

Trauma systems are intended "to ensure each patient is properly triaged and matched to the hospital with the most appropriate resources as quickly as possible," explained Chris Tilden, Kansas Office of Local and Rural Health director. "Kansas had systems in place before the creation of the trauma system but no formal process for regional or statewide coordination. There was communication on the local level, but no systematic process."

Kentucky is one of the states without a trauma system for routing critically injured people to the closest appropriate trauma center.

"The death rate in rural parts of Kentucky is more than 50 percent higher than urban areas," said Dr. Jeffrey Coughenour, a trauma surgeon at the University of Kentucky Chandler Hospital in Lexington. Frustrated by the lack of a trauma system in Kentucky, Coughenour, the Kentucky State Office of Rural Health and other medical providers are developing a regional trauma care plan.

Kentucky has three Level I centers, one Level III center and many capable EMS providers, Coughenour noted. But the trauma centers are all located in the state's center, care is fragmented and rural people in border areas are a considerable distance away. In the last six months, Coughenour said they have established a regional trauma advisory council, developed a systematic triage protocol for participating providers and have been offering Rural Trauma Team Development courses in small hospitals. With the eight-county area surrounding Lexington involved now, they plan to extend efforts to other area counties.

Coughenour said health care providers and public surveys indicate support for a statewide trauma care system, but numerous legislative acts have been introduced over the years and never passed.

"We take care of these people every day and we know how it needs to work," he said. "We can't wait any longer. It's irresponsible of us as leaders in trauma care not to act. The state has not made any progress in coming up with a coordinated trauma plan in the last 10 years.

Rural Hospitals Playing a Stronger Role in Trauma Care

In states where trauma care systems are in place, rural care is being enhanced through inclusion of Critical Access Hospitals (CAHs) as lower-level centers. The Office of Rural Health Policy at HRSA is requiring all State Rural Hospital Flexibility Programs, as of this year, to work with CAHs in their states to get them certified as Level III and IV trauma centers. (For more information, see the Rural Health Resource Center's Emergency Medical Services (EMS): Tools for State Flex Programs.

Dr. Jim Harris is the trauma medical director at Riverwood HealthCare Center in Aitkin, a CAH that is Minnesota's first Level III center. Harris said Level I and II centers are approximately 2½ hours by ground and 40 minutes by air from Aitkin.

"I think what's most helpful about this is that EMS providers know now what we can take care of in our hospital and what they'd be better off sending directly to Level I or II," Harris said. "Before, doctors made that decision on the fly as patients came in the door. Treatment is rendered more quickly and more consistently. Training for our smaller hospital is a big part of it too. Having everyone know what constitutes a trauma alert and what's expected in patient management certainly benefits patients and outcomes."

Rural hospitals provide resuscitation, stabilization and transfer to higher-level care centers. Washington, which has 23 CAHs in its system, has designated Levels I-V for trauma centers.

"From the very beginning, rural hospitals were involved in the planning system," Schmitt said. "We have a lot of wilderness areas. Those patients would die, I'm sure, if these rural hospitals didn't fill the role they do in our trauma plan."

Working Toward Coordinated Care Nationwide

Washington and Kansas are among states that have reciprocal agreements with bordering states. Patients are transported to the closest facility, regardless of state lines. Branas and his colleagues have recommended that all state plans should share trauma care resources across borders to improve access.

While the number of trauma centers has increased, no national plan exists to ensure access for everyone. Geographic distribution of trauma centers and service coordination varies widely from state to state, Branas said.

Trauma systems face numerous challenges, primarily related to high expenses and limited state and federal funding. The HRSA national assessment survey concluded, "... economic support for trauma systems appears to be a major concern among all states."

Rod Landrum, who celebrates life every day, wants to raise public awareness of the need to support trauma systems in each state and develop coordinated trauma care nationwide.

"I believe I need to give back to the system that saved my life," he said. "My goal is to speak out wherever the opportunity presents itself. If I just help save one life through my efforts, then I will know I am serving a greater cause."

Landrum would be happy to speak to anyone about his experience. He can be contacted at rod[at]wavewls.com

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