TRAUMA CARE IN ALASKA-2011 - Alaska Department of Health

57 Pages·2011·1.56 MB·English

TRAUMA CARE IN ALASKA-2011
Frank Sacco MD, FACS
Chair, Trauma System Review Committee
GOALS
The scope of the problem.

How best to care for seriously injured patients

How we care for them now in Alaska

How we can do better- examples

Recommendations

Trauma in Alaska
The leading cause of death under age 44.
Alaska- second highest trauma mortality in the US

400-500 alaskans die each year.

~ 5000 hospital admissions.

Over 1000 with permanent disabilty.

All Cause Mortality Alaska
10 Leading Causes of Death, Alaska

2005, All Races, Both Sexes

Age Groups
Ran All
<1 1-4 5-9 10-14 15-24 25-34 35-44 45-54 55-64 65+
k Ages
Congenita
Unintentio Unintentio Unintentio Unintentio Unintentio Unintentio Malignant Malignant Malignant Malignant
l
1 Anomalie nal nal nal nal nal nal Neoplasm Neoplasm Neoplasm Neoplasm
Injury Injury Injury Injury Injury Injury s s s s
s
15 4 3 13 47 54 55 104 163 419 732
Congenita Congenita
Unintentio Malignant
2 Innjualr y Anoml alie Neopsl a sm Anoml alie Su3ic1id e Su2ic3id e Su3ic4id e DHiseeaarste DHiseeaarste DHiseeaarste DHiseeaarste
s s 71 111 405 627
13 2 2 1
Maternal Congenita
3 PCreog7myn a pn. c Hom1ic ide Anom1sl a lie DHisee1aa rste Hom1i0c i de Hom1i0c i de MNeaoli3gps0nl a a snmt UnIinnn5jtua6elr n y t i o UnIinnn2jtua9erln y t i o Cvae1srec3ub9lr ao r- UnIin3nnj1tuae3rlny t i o
Chronic Chronic
Short Heart Malignant Heart Low. Low. Cerebro-
4 Gest6a t ion Hom1ic ide Dise6a se Neopsl a sm Dis2e6a s e Su2ic6id e Respyi rator Respyi rator va1sc7u8l a r
7 Disease Disease
26 117
Chronic
Malignant Malignant Heart Liver Liver Cerebro- Alzheimer' Low.
5 Hom2ic ide Neopsl a sm Neopsl a sm Dise6a se Dis1e0a s e Dis1e6a s e vas1c9u l ar Disesa se Respyi rator
1 6 60 Disease
158
Chronic
Necrotizin
6 Entegro coli Meningitis Cvaesrecublraor- DMiaeblleitutess Cvaesrecublraor- ReLspoiwra. tor DMiaeblleittuess DMiaeblleittuess Suicide
t2is 1 1 2 7 Diseya se 17 57 131
14
Congenita
Unintentio
7 SI2D S Anoml alie Nep2h r itis Hom6ic ide DMiaeblleitutess DiLsievaesr e Innjuarly DMiaeblleittuess
s 14 12 93
1 39
Congenita Influenza Influenza
8 TSieixd DMiaeblleitutess Anoml alie Septaic e mi Cvaesrecublraor- Pneu&m oni Pneu&m oni Alzhesi mer'
1 1 1s 4 12 1a1 3a0 Dis6e1a s e

9 TSieixd Pnetuism oni TThierede TThierede Sui9ci d e Nep2h8r i tis DLisievears e
1 1 2 5 52

Influenza
Parkinson'
Six Three Three Septicemi &
10 Tied Tied Tied a Disesa se Pneumoni
1 2 5 7 a
22 44
WISQARSTM Produced By: Office of Statistics and Programming, National Center for Injury Prevention and Control,

Centers for Disease Control and Prevention
Data Source: National Center for Health Statistics (NCHS), National Vital Statistics System
Trauma Mortality in Alaska
Age Adjusted Trauma Mortality
300
250
200
0
0
0,0 US
0
1 150 ALL ALASKANS
/s
hta ALASKA NATIVES
e
d
100
50
0
1 3 5 7 9 1 3 5 7 9 1 3 5
8 8 8 8 8 9 9 9 9 9 0 0 0
9 9 9 9 9 9 9 9 9 9 0 0 0
1 1 1 1 1 1 1 1 1 1 2 2 2
year
Trauma in Alaska
Motor vehicle crashes leading cause of death.

Firearm related injuries, second.

2009 hospital costs - Alaska trauma patients over $121

million.
Medicaid & Workmans Comp 26 million hospital costs.

(900 admissions)
~ 20% trauma admissions uncompensated.

Death from Trauma
50
45
40
35
30
25
20
15
10
5
0
Immediately Hours Days -Weeks
Trauma Systems
A trauma system consists of hospitals, personnel,

and public service agencies with a preplanned
response to caring for the injured patient.
Trauma Systems
“Getting the right patient to the right place in the
right amount of time.’
Facilities (trauma center designation)

Personnel (training)

Patient transport

Triage

Trauma Systems
“15-20% improvement in survival of the seriously

injured.” NEJM 1999
Increase productive working years

Improve statewide disaster preparedness.

Inclusive systems -best
