Indiana considers 30-minute trauma system rule


INDIANAPOLIS - Top state health officials say it's time to improve your chances of surviving a critical incident. They're proposing a state-wide trauma system that could include a 30-minute transportation rule.

For the first time, Indiana is considering a mandate on how quickly trauma patients get to trauma care.

In Orange County, California, preventable deaths fell from 72 percent down to nine percent under a similar plan.

Indiana's state health commissioner says it's time Indiana follow other rural states like Texas, Minnesota and Alabama, and save more lives.

Down the road from Ron Tennell's car repair, Trevor Goldsmith died.

"He got killed there pulled out in front of traffic," said Tennell, referring to the July 14th accident involving the 19-year-old.

In March, along the same stretch, Rachel Gaskin could have met the same fate. Her infant son Mason and boyfriend Justin Dorris died when their car crashed head-on into a dump truck.

"It was a bad one," said Tennell, who remembers driving up to the scene after Gaskin had been loaded on the helicopter.

Air-lifted with critical injuries to an Indianapolis trauma center, she survived.

"That first golden hour the treatment has to be accurate and timely," said State Health Commissioner Dr. Gregory Larkin. He was highlighting the need for quick responses to reduce the potential for death or long-term disability.

Some of Indiana's top health and emergency responders recently packed inside a Noblesville firehouse to discuss the issue of response time. They want to save more lives by getting trauma patients to the closest trauma center in the least amount of time.

"I don't think anybody in this room disagrees that we need trauma rules," said one ambulance provider from northern Indiana.

The big problem is Indiana is largely rural. Medical air-lifts like LifeLine are not always available.

Ron Tennell knows. He's responded to violent crashes in Flat Rock as a former volunteer firefighter.

"LifeLine comes to us from the north or south, and it really depends on the weather," he added.

EMS Commission Board Member Myron Mackey, who lives near Evansville, says the state has to take into consideration the need for flexibility in rural areas.

"When that 90-year-old cracks her head in the nursing home, if the protocol says I've got to take her to a trauma center, I've got to take her to a trauma center and I need somebody that I can call up and say look, 'The rules say this, can we not take her, can we take her to a local facility here?'," he said, giving a hypothetical situation where the closest hospital might be the best answer.

"However it's written, it does need to be written in a way that takes into account that most areas in the state don't have a trauma center within 30 minutes," responded Dr. Lewis Jacobsen, the Trauma Director at St. Vincent Hospital in Indianapolis.

A statewide EMS committee is considering the 30-minute rule.

Weeks ago, 13 Investigates discovered the state has no rules when it comes to response times for ambulances getting to critical emergencies or transporting patients.

Some nursing homes were even calling private ambulance crews from across town in life and death situations when fire department paramedics were right around the corner. A nursing home patient actually died in that case.

13 Investigates spoke with Dr. Larkin about the troubling response times we found.

"One of the issues that this agency has struggled with is this whole time issue no matter what the emergency, because there are no time specifications," 13 Investigates pointed out.

Dr. Larkin acknowledged the problem and reiterated a need for change.

"The guidelines that we have been working with do insert time. About 30-minutes for ground transportation, 45 [minutes] by air," he said.

The proposed time limits would only apply to transporting trauma patients, assuming ambulances get to them without delay.

"The common sense is let's all at least read from the same book, and understand that if you're in a rural county and there's no trauma center within two hours, there's not much you can do, of course," explained State Health Commissioner Larkin.

The 30-minute rule is still under consideration. The plan would also include set guidelines for evaluating patients and trauma centers themselves.

Gov. Mitch Daniels has directed that a system be in place by October 2012.