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Trauma flights on the rise in St. Lucie County

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  • Trauma flights on the rise in St. Lucie County

    Trauma flights on the rise in St. Lucie County

    The two regional trauma centers are working to cope with more cases from the Treasure Coast.

    By Derek Simmonsen staff writer
    October 19, 2003

    ST. LUCIE COUNTY — In just two hours, four people found themselves fighting for their lives.

    A pickup truck hit a light pole on U.S. 1 and Orange Avenue; a motorcycle wrecked near 13th Street and Boston Avenue; a vehicle crashed on Orange Avenue and 33rd Street, and a man was stabbed at a restaurant.

    The night of Sept. 26, three helicopters flew four injured people to regional trauma centers. It was the busiest night in a week that saw 14 people airlifted with a host of serious ailments.

    "Our numbers are steadily increasing," said Battalion Chief Carlos Duran, a St. Lucie County Fire District spokesman. "We're anticipating (flying) about 200 people this year."

    The rising number of trauma patients in St. Lucie County has not gone without notice at the region's two trauma centers — Holmes Regional Medical Center in Melbourne and St. Mary's Medical Center in West Palm Beach. They, too, are working to accommodate the growing number of local residents who need advanced care.

    Most of the time, it begins with an accident.

    Calling in the chopper

    The term "trauma" describes injuries from blunt force (such as car accidents), penetration (such as gunshot or stab wounds) and burns, said Tracy Mahank, director of trauma and critical care for St. Mary's Medical Center.

    When paramedics respond to a call, they run down a long "scorecard" to determine whether a patient warrants a trauma alert.

    They check the airway and circulation, evaluate motor skills, look for burns or amputations and determine whether any major bones have been broken.

    "(Paramedics) do a very good job of getting the patients to us in a hurry," Mahank said. "They're a very important part of the trauma system and they deserve a great deal of credit."

    St. Lucie County's Air Rescue 1 helicopter makes most of the flights. When the local helicopter is not available, helicopters from Martin or Brevard counties fill in.

    St. Lucie County patients do not have to pay to travel on Air 1. However, they will be charged if they are picked up by Martin County's LifeStar or Holmes LifeFlight.

    "The patient is directly responsible for the cost," Duran said. "The fire district does not incur any cost and neither does the sheriff's office."

    Insurance will often pay the cost of the ride, but if the patient is indigent, the costs are absorbed by Holmes and CJ Aviations, respectively. CJ Aviations manages LifeStar as a public-private partnership with Martin County.

    Which helicopter makes a pick-up on a busy night can be a matter of chance.

    The 'golden hour'

    The new $2.6 million Air Rescue 1 has had plenty of flight time since it came into service in April.

    "In large part, it has a lot to do with population growth and traffic," Chief Deputy Garry Wilson said. "These are factors that we're experiencing all throughout the Treasure Coast."

    The average cost to fly the helicopter is about $250 an hour, and the average flight is under two hours, Wilson said. Sheriff's office pilots work 24-hour shifts and fly medical and law enforcement missions, he said.

    At least one, if not two, paramedics accompany the patient on the average 20- to 25-minute flight, Duran said.

    By the time patients reach a facility such as St. Mary's, there is already a team of nurses, doctors and technicians waiting. Equipment is reserved for severe emergencies and an operating room is always open.

    "They don't wait to find out if a patient needs to come to surgery," Mahank said. "When the decision comes, they are ready to go."

    When talking about trauma, one phrase often comes up: the golden hour.

    "The golden hour starts at the time you're injured," Mahank said. "Trauma is a disease of bleeding. ... The faster you can stop the bleeding, the more likely you are to survive that injury and not develop complications. Sometimes, 10 minutes is life and death for patients."

    St. Mary's and Holmes have seen the number of patients from St. Lucie County and the rest of the Treasure Coast increase steadily during the past few years. St. Mary's is awaiting final approval to add a second helicopter pad to handle more than 700 helicopter landings a year.

    "The busier you get, the resources are tapped more quickly, more often," said Don Chester, an associate administrator for St. Mary's. "We are now starting to see a volume of patients from other counties where we would start looking for support from those counties."

    Holmes LifeFlight bills patients for the flight, often through insurance, but eats the cost of indigent care, said Chris McGahee, a hospital spokesman. In 2001, the trauma center performed about $3 million in charity care.

    St. Lucie officials have talked with St. Mary's officials about sharing costs, but the idea is not very popular, County Administrator Doug Anderson said. Another possibility is creating a trauma center on the Treasure Coast, but the cost is a major deterrent.

    "There probably would have to be some kind of health-care district," Anderson said.

    "I think in the future there is going to be a need for a trauma center in this region," said Beth Tuttle, a spokeswoman for Lawnwood Regional Medical Center & Heart Institute in Fort Pierce.

    The high initial expense and ongoing expenses associated with a trauma center would mean that the hospital would need public funds to pay for the increased costs, she said.

    - [email protected]

    By the numbers

    •St. Lucie County expects to fly 200 patients to trauma centers in 2003.

    •St. Mary's Medical Center in West Palm Beach treats about 1,600 trauma patients a year.

    •Holmes Regional Medical Center in Melbourne expects to treat 1,300 this year.

    •Unintentional injuries were the No. 1 cause of death for Floridians ages 1 to 44 in 2000.

    Trauma breakdown at St. Mary's:

    •80 percent blunt trauma (falls, car accidents)

    •19 percent penetration (stabbings, gunshots)

    •1 percent burns
    Ladders dont put out fires... water puts out fires... engines companies rule.

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