PVMC aims to upgrade on-site trauma service in the future

By Kevin Denke
Posted 4/18/12

    BRIGHTON – The intersection of Interstate 76 and Bromley Lane has seen its share of accidents in the last 15 months.

    Through mid-March, 15 collisions …

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PVMC aims to upgrade on-site trauma service in the future


    BRIGHTON – The intersection of Interstate 76 and Bromley Lane has seen its share of accidents in the last 15 months.
    Through mid-March, 15 collisions have taken place there, according to Brighton police.
    One of the most recent was March 1. Brighton resident Nicole Mascarenas, 24, sustained serious injuries when her SUV rolled. Two of her three children escaped injury.
    Platte Valley ambulance paramedics, who treated Mascarenas at the scene, were in touch with physicians at nearby Platte Valley Medical Center. But Macarenas didn’t go there for treatment. She went to a facility that offered more specialized care for her injuries. Mascarenas continues to recover from her injuries.

    It happens frequently with seriously injured patients. PVMC Chief Operating Officer Kurt Gensert said it might not be the most convenient means of treating seriously injured patients, but “it is the most logical.”
    Gensert said there are three parts to trauma care. One involves immediate death, such as a patient who hits the wheel and hemorrhages. The second involves a patient who could be saved in what’s called “the Golden Hour,” the first 60 minutes after a serious injury. Most have unseen injuries. The third involves patients who die some days or weeks afterward because a specific incident began a series of internal problems, such as pneumonia.
    Former Sen. Ben “Nighthorse” Campbell championed a bill that streamlined hospitals’ levels of trauma service in the mid-1990s. The facilities are set off in four groups according to what and who is available in a given facility.
    “Denver Health is a Level 1 facility. It has the most advanced, most elaborate infrastructure. That’s the direction they chose to go,” Gensert said. “A Level 2 hospital has a lot of the same resources. But it lacks a couple of key specialists, such as a neurosurgeon.”
    Platte Valley is a Level 4 facility which, among other things, means it doesn’t have trauma specialists in the hospital 24 hours a day, seven days a week.
When a seriously injured patient is in need of medical assistance, the care begins as soon as medical help arrives. Part of the job in the field is what Gensert called “destination protocol.”
    “If I fall off a roof that is higher than 15 feet, the chances that I have more than a broken leg are pretty high,” Gensert said. “I would have to be moved to a higher level of trauma care.”
    That’s where the statewide network of levels of trauma-care providers comes into play. The Platte Valley Medical Center and Denver Health Medical Center are partners, even to the extent of providing follow-up summaries of patient care.
    “The physicians are in constant contact with the paramedics. It is a well-refined system in Colorado,” Gensert said. “If an unrestrained patient has been ejected from a moving vehicle at 50 mph, they don’t need to ask one more question. That patient is going to a Level 1 facility.”
    Part of the statewide trauma network is the result of specialized medicine.
    “If a patient has a cervical fracture, that probably isn’t the only injury,” Gensert said. “General physicians do not do all those surgeries. Once, it was global. General surgeons did hip replacements. Now, you have general surgeons, surgeons who specialize in breast cancer. Trauma surgery is a sub-specialty.”
    Gensert said Platte Valley paramedics approach each patient with an approach of “the injury is there until proven otherwise.”
    “If I come to Platte Valley with a blunt abdominal injury from a car accident and have been evaluated, if it looks like I need emergency surgery, then I would be taken to a Level 1 hospital. The most recent survey put us at Level 4 with no recommendations. We like the relations between our EMS and our ER staff. We like the great quality outcome.”
    At one time, Platte Valley took in seriously injured patients.
     “Trauma care is important to us, and we are committed to doing it well,” Gensert said. “A Level 3 designation could be important. But not now. Any new service has a cost. We have to look at the demand. We have an especially well-organized system. We’re triaging folks so they are in the right place. If we were all in silos and not working with one another, there would be more risk.
    “If hospitals threw open their doors to everyone, I think you’d see a lot different results,” Gensert added. “It’s cost effective. It’s not the most convenient. But it is the most logical.”

Contact Steve Smith at ssmith@metrowestnewspapers.com r at 303-659-2522, ext. 224.


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