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Fri, Jan. 17

What happens in Kingman will stay in Vegas
KRMC says small size of city precludes treating serious trauma patients here

KINGMAN - Kingman Regional Medical Center eventually will hold a designation as a trauma facility, although it will not significantly change services now performed there.

"A designation does not matter as far as the care we provide and where patients are sent," said Brian Turney, hospital chief executive officer. "We feel we can meet the Level III designation. We don't have to get it but plan to do so."

Level III requirements already in place at KRMC include general and orthopedic surgery, radiology services, 24-hour operating room availability, and intensive or critical care with such unit(s) staffed by registered nurses with trauma training.

In order to gain a Level I or Level II designation, a hospital must be able to perform neurosurgery. That is not a present capability at KRMC.

"You typically need a 100,000 population base in a community to be able to support a neurosurgeon, so Kingman must continue to grow before that becomes possible," Turney said.

Patients with brain injury, gunshot wounds and other severe types of trauma are airlifted after being stabilized at KRMC. Several air ambulance services fly by helicopter from KRMC to University Medical Center in Las Vegas or St. Joseph's Hospital in Phoenix.

Flying times normally are 40 minutes to Las Vegas and 1 hour, 20 minutes to Phoenix, said paramedic Darren Winters, who flies aboard Kingman Ranger, the Arizona Department of Public Safety air rescue helicopter. The cost to patients can be thousands of dollars for an airlift, much of which is paid by insurance depending on coverage.

"A trauma designation will make no difference in what we're now doing," Turney said.

"We take care of trauma, depending on specialty needs. We don't do neurosurgery and have no plans for it in the near future. The patient comes here to be assessed and if a particular service is not available would be stabilized and shipped out.

"Injuries within our realm such as orthopedic we treat and take care of here."

It probably will be another year before the Level III trauma facility designation is sought from the State Trauma Advisory Board, which works with the Arizona Department of Health Services. The two bodies began drafting rules for trauma facility designations in August 2004.

On Oct. 6, 2005, the Governor's Regulatory Review Council unanimously approved the ADHS trauma center designation rules, according to information posted on the ADHS Web site.

STAB is systematically working to give all Arizona hospitals a trauma center designation from Level I to Level IV, Turney said. It presently is concentrating on Level I, the highest designation.

The criteria adopted by the state closely mirrors national trauma center designations created by the American College of Surgeons, he said.

"(Prehospital coordinator) Sue Kern has indicated we could petition to have them look at us sooner, but we don't see a strong need to do so," Turney said.

"I think it will happen within the next year. Whenever they're ready, we'll be ready and will petition them at the appropriate time."

Criteria for a particular designation are broken down into 11 categories and include institutional organization, hospital departments/divisions/sections, clinical capabilities, clinical qualifications, facilities/resources/capabilities, rehabilitation services, performance improvement, continuing education/outreach, prevention, research, and additional requirements for trauma centers represented as caring for pediatric trauma patients.

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