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Trauma Services FISCAL YEAR STATISTICS 2005 ANNUAL REPORT. The Medical Center of Louisiana is a member of the LSU Health Sciences Center – Health Care Services Division, and is affiliated with LSU and Tulane Schools of Medicine. Table of Contents. 2. - PowerPoint PPT Presentation
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The Medical Center of Louisiana is a member of the LSU Health Sciences Center – Health Care
Services Division, and is affiliated with LSU and Tulane Schools of Medicine.
Trauma ServicesFISCAL YEAR STATISTICS
2005ANNUAL REPORT
Table of Contents
2
I. Introduction Trauma Program Representatives ..........................................3 Trauma Program Overview....................................................4
II. 2005 Fiscal Year Report – Patient Statistics Patient Demographics ............................................................9 Fatal Trauma ..........................................................................10 Parish of Injury Vs. Residence...............................................11 Patient Triage Summary ........................................................12 Mechanism of Injury..............................................................13 Severity of Injury ...................................................................14 Patient Transportation ............................................................15 Injury Severity Score (ISS) by Mechanism of Injury ...........16 Etiology By Intent..................................................................17 Intentional Injuries .................................................................18 Trauma Activation Levels by Injury Severity Score .............19 Vehicular Trauma ..................................................................20 Emergency Center Trauma Admissions by Day Of Week ....21 Emergency Center Trauma Admissions by Shift...................22 Emergency Center Major Trauma Patient Turnaround Time.23
Emergency Department Disposition ......................................24 Admitting Service ..................................................................25 Procedures on Trauma Patients..............................................26 Head Injury ............................................................................27 Spinal Injury...........................................................................28 Hospital Discharge Disposition .............................................29 Eye & Organ Procurement.....................................................30 Drug & Alcohol Results for Trauma Activations ..................31 Reimbursement Summary......................................................32 FY 2003 Spreadsheet Comparison
- Slides 9-10 ...............................................................33 - Slides 11-14 .............................................................34 - Slides 15-16 .............................................................35 - Slides 17-19 .............................................................36 - Slides 21-24 .............................................................37 - Slides 25-38 .............................................................38 - Slides 29-32 .............................................................39
III. Other American College of Surgeons Certificate of Verification....40 Louisiana Department of Health & Hospitals License ..........41
TRAUMA PROGRAM REPRESENTATIVESNorman McSwain, MD, Trauma Program Director
Trauma Program Manager
Eileen Mederos, RN
Trauma Coordinators
Cynthia Armstrong, RN
Sharon Carter, RN
Mary Anne Ernst, RN
Bridget Schumert, RN
Donna Welsh, RN
Robin Whitfield, RN
Trauma Program Secretary
Angel Johnson
Trauma Registry
Med. Rec. Services Dir., Carroll Johnson, RHIT
Admin. Manager, Miriam Roberts, RHIT, CTR Data Manager, Vicki Holloway, RHIA, CCS
General Surgical Services
Alan Marr, MD
Sharon Weintraub, MD
Orthopedic Services
Barry Riemer, MD
Phyllis Carboni, RN
Emergency Medicine Services
Kathleen Hubbell, MD
Jullette Saussy, MD
Associate Dir., Trauma Program
John Hunt, III, MD, MPH
Director, Neurosurgical Trauma
Deepak Awasthi, MD
Director, Emergency Medicine
Jorge Martinez, MD, JD
Director, Orthopedic Trauma
Kyle Dickson, MD
Director, Trauma Rehabilitation
Gary Glynn, MD
Physical Medicine and Rehab
Mary Daut, MD
Diagnostic Radiology
Erick Blaudeau, MD
Neuro-Surgical Services
Michael Carey, MD
Anesthesiology
Alan Kaye, MD
Pediatric Intensivist
Olugbenga Akingbola, MD
Gary Duhon, MD
Edwin Frieberg, MD
Nursing Administrators
Emergency Services
Olander Holloway, RN, JD
Perioperative, Critical Care Services
Betty J. Adams, MN, RN
Case Management
Charlotte Godchaux, MN, RN
New Orleans Health Department
Director, Kevin Stephens, Sr. , MD, JD
Perioperative Services Joan Heck, MSN, RN
Emergency Center Kevin Beck, BSN, RN
Surgical Intensive Care Unit Mary Luce, RN
Surgical Intermed. Care Unit Vicki Hirsch, BSN, RN
Neuro Science Center Frida Orrego, RN
Medical Intensive Care Unit Dan Kiff, BSN, RN
Operating Suites Kevie Richardson, RN
Blood Bank Cynthia Eicher, MHS, MT
Anesthesia Jay Buras, CRNA
Respiratory Therapy Nelson Page, RRT
Physical/Occupational Therapy Anna Smith, PT
Continued Care Coordinator Karen Chabert, RN
University Hospital-ED Gaynell Grieg, RN
3
TRAUMA PROGRAM OVERVIEW
The Trauma Program at the Medical Center of Louisiana operates under the guidance of
the Director of Trauma, with the 24-hour support of the departments of Surgery, Emergency Medicine,
Orthopedics, Neurosurgery, Radiology, Pathology, all Surgical subspecialties, Blood Bank, Nursing, and
Allied Health personnel. The Trauma Program includes full-time in-house faculty who manage and
supervise resuscitation and surgical interventions in all cases. On April 9, 1996 the American College of
Surgeons verified Charity Hospital as a Level I Trauma Center. This verification is for three years, and
the Trauma Center successfully underwent re-verification March 5, 1999 and again in March 2002.
With over 4,000 trauma patients a year, this makes Charity’s Level I Trauma Center one of the busiest
verified inner-city centers in the country. Subsequently, the Trauma Center has been licensed and
designated as a Primary Trauma Center by the Division of Health and Human Resources according to
state statute.
4
Since its inception, Trauma Team members have consistently filled a leadership role in the
development and implementation of optimal trauma care for the State of Louisiana. Responsibilities are
held within the following committees and organizations:
• American Association for Parenteral and Enteral Nutrition
• Louisiana State Committee on Trauma
• American Association for the Surgery of Trauma • Louisiana State Highway Safety Council
• American College of Surgeons Committee on Trauma • Metropolitan Safety Council
• American Nurses Association • Society of Trauma Nurses
• National and International Surgical, Orthopedic, and NeuoSurg Assoc.
• American Trauma Society
• Eastern Association for the Surgery of Trauma
• New Orleans Surgical Society
• Emergency Nurses Association
• Orleans Parish Medical Society
• Gubernatorial Ad Hoc Committee on Trauma 5
The in-house Trauma Team consists of an attending trauma surgeon, chief surgical resident,
and additional surgical residents at other levels. The surgical faculties are trauma-committed surgeons
with special interest and expertise in trauma care. The Trauma Team evaluates, resuscitates and
definitively treats all major traumas.
In addition to the medical support, trauma office staff are fundamental to Charity’s trauma
services progress, execution and evaluation. Working in conjunction with the Director of the Trauma
Program, the Trauma Program Manager and the Coordinators are responsible for the organization of
services necessary for an interdisciplinary approach in the delivery of optimal care to the trauma
patient. Clinical monitoring, concurrent performance improvement, and community outreach and
prevention programs are but a few of the services implemented by the Trauma Program personnel.
While the main goal of the Trauma Service is optimal patient care, the service also provides
leadership in education and research. There are on-going educational programs for nursing, residents
and students in the form of attending rounds and operative supervision as well as didactic discussions
and conferences. Trauma surgical faculty members are nationally and internationally recognized for
their expertise in research, and research work done at the Trauma Center has been presented many
times at the national and international levels.
6
Trauma Team member education is pre-eminent for the Trauma Services. Outreach and
educational efforts occur simultaneously. The Trauma Program has become a well-recognized
educational resource and has not only been the preceptor of students from many colleges and
universities in our own community, but has received medical personnel from all over the world wanting
to interact with the Trauma Center. A strong part of the Trauma Program’s outreach is providing
education to all care providers. This is accomplished through a variety of mechanisms, including
monthly orientation of new hospital personnel to their responsibilities within the Trauma Center,
monthly interdisciplinary trauma care conferences, and continuing staff in-services, workshops, and
updates on the optimal care of the trauma patient to prehospital care providers, physicians and nurses.
In addition, the Trauma Committee members organize and teach trauma education courses. These
courses include but are not limited to, Advanced Trauma Life Support, Advanced Cardiac Life Support,
Trauma Nurse Core Curriculum, and Advanced Trauma Care for Nurses.
A Level I Trauma Center has the highest level of response for the major trauma patient, as
well as trauma related research, teaching and outpatient care programs. The Trauma Team requires
the cohesive medical approach of physicians, nurses, technicians and ancillary staff to assure that the
trauma patient is evaluated, resuscitated and treated expeditiously and appropriately. In addition, the
program continues to be active in allied initiatives with one of the most active trauma injury prevention
programs in the country, to our rehabilitation with the overall objective to continually reduce deaths
and disabilities from trauma. 7
MEDICAL CENTER OF LOUISIANAMEDICAL CENTER OF LOUISIANACHARITY HOSPITALCHARITY HOSPITAL
TRAUMA PROGRAMTRAUMA PROGRAMANNUAL REPORTANNUAL REPORT
Patient StatisticsPatient Statistics
Fiscal Year
2005
PATIENT DEMOGRAPHICSn = 3907n = 3907
RACE
White33% Black
62%
Asian1%
Other4%
AGE
Elderly3%
Adults89%
Peds8%
GENDER
Female23%
Male77%
Trauma is endemic in young Afro-American males in Orleans Parish. These data mirror national data which demonstrate that trauma is a disease of young people
and the #1 cause of death in people less than age 44.
(Pediatrics: 0-12; Adults: 13-64; Elderly 65+)
FY 2005
MCLNO Trauma Registry 9
FATAL TRAUMAn = 192n = 192
RACE
White38%
Black57%
Asian2%
Other3%
AGE
Elderly7%
Peds4%
Adults89%
GENDER
Female18%
Male82%
Overall trauma patient mortality was 4.9%. Of these, 52% (100) either expired in the Emergency Department or were DOA. There were 92 in-hospital deaths
representing 4.2% of all admitted trauma patients.
FY 2005
MCLNO Trauma Registry 10
PARISH OF INJURY vs. RESIDENCEn=3907n=3907
46% of patients treated were residents of parishes other than Orleans. Patients who were known to be injured in outside parishes accounted for 10% of all evaluations
and/or admissions. The actual number increased from 417 last year to 585 this year. This increase is the result of recent contractual agreements with outside parishes.
Parish of I njury
Plaque-mines1%
Unknown32%
Other3%Wash./ St.
Tamm2%
Saint Bernard
1%
J efferson8%
Orleans53%
Parish of Residence
Plaque-mines1%
Unknown1%
Out of State3%
Wash./ St. Tamm
5%
Other14%
St. Bernard4%J efferson
16%
Orleans56%
FY 2005
MCLNO Trauma Registry 11
PATIENT TRIAGE SUMMARYn=2092n=2092
True +43%
False +39%
False -13%
True -5%
True + {Predicted Major Trauma/Actual Major Trauma
True – {Predicted Non-Major Trauma/Actual Non-Major Trauma
OVERTRIAGE=False + {Predicted Major Trauma/Actual Non-Major Trauma
UNDERTRIAGE=False – {Predicted Non-Major Trauma/Actual Major Trauma
FY 2005
MCLNO Trauma Registry12
MECHANISM OF INJURYn=3907n=3907
Blunt71%
Burn1%
Penetrating28%
Blunt trauma accounts for 71% of all trauma cases seen by this facility, which is designated as the official Orleans Parish Trauma Center. Penetrating trauma
accounts for 28% which has increased by 5% since FY 2004.
FY 2005
MCLNO Trauma Registry13
SEVERITY OF INJURYn=3907n=3907
Major & Non-Fatal
50%
Major & Fatal5%
Minor45%
Fifty-five percent (55%) of the injured patients treated by the MCLNO Trauma Center were victims of Major Trauma.
Major Trauma
Includes any patient who is known or reasonably suspected to have sustained an injury that merits treatment by a trauma team capable of immediate surgery and one or more of the following:
1) Transfer from another hospital,
2) Admission to ICU,
3) Hospitalization for three or more days,
4) Abbreviated Injury Scale Value of 3 or more
5) Survival probability 90% or less, or
6) Death.
FY 2005
MCLNO Trauma Registry 14
PATIENT TRANSPORTATIONn=3907n=3907
OverallTransports
Inter-hospitaln=57615%
Pre-hospitaln=2623
67%
Self13%
Police3%
Other2%
PrehospitalTransport
West Jeff6%
Guardian1%
Other EMS 6%
East J eff5%
Acadian5%
NOHD72%
Lifeguard2%
Air3%
I nterhospitalTransport
NOHD9%
Other EMS21%
AMR1%
EmergyStat4%
Air EMS11%
AMED2%Acadian
EMS52%
Seventy-nine percent (79%) of patients transported were brought to MCLNO via an ambulance. The New Orleans Health Department ambulance service, was
responsible for 72% of the pre-hospital care.
FY 2005
MCLNO Trauma Registry15
INJURY SEVERITY SCORE (ISS)BY MECHANISM OF INJURY
n=1500n=1500**
167
86
118
149
278
167
665454
48
159154
0
50
100
150
200
250
300
ISS 1-5 ISS 6-10 ISS 11-15 ISS 16-20 ISS 21-25 ISS >25
# o
f P
ati
en
ts in
Th
ou
sa
nd
s
BLUNT
PEN
The injury severity score (ISS) is a way of assigning severity of injury numerically for standardization and outcome prediction. ISS is related linearly with mortality, and an ISS >= 15 is considered major trauma.
*Activated Patients who were either
admitted or died in the ED.
FY 2005
MCLNO Trauma Registry 16
ETIOLOGY BY INTENTn=3907n=3907
Accidental66%Assault
31%
Undetermined2%
Self-Inflicted1%
Thirty-one percent (31%) of all patients seen and treated were victims of intentional assault. Violence prevention remains a top priority of the Trauma
Center’s Outreach and Community Activity Program.
FY 2005
MCLNO Trauma Registry17
INTENTIONAL INJURIESn=1296n=1296
Stab24%
Other25%
Firearm48%
Self-inflicted3%
vs. Another97%
Where the data are known, 97% of intentional injuries were the result of an assault and 3% were self inflicted. Gunshot and stabbings continue to be the
major cause of intentional injuries.
FY 2005
MCLNO Trauma Registry 18
TRAUMA ACTIVATION LEVELSBY INJURY SEVERITY SCORE
n=1502n=1502**
Injury Severity Score
Of the 3,880 trauma patients for fiscal year 2005, 3,097 (79%) required trauma system activation. Fifty percent (50%) of these were designated as needing the
highest level of Activation.
0
50
100
150
200
250
300
350
ISS 1-5 ISS 6-10 ISS 11-15 ISS 16-20 ISS 21-25 ISS >25
Regular
Partial
*Activated Patients who were either admitted or died in the ED.
FY 2005
MCLNO Trauma Registry 19
VEHICULAR TRAUMA
Protective devices are seat belts, air bags, child seats, and helmets. Seat belt usage decreased from 61% to 48% while motorcycle helmet usage increased from 36% in FY 2004 to 61% in FY
2005. Bicycle helmet usage was documented in 4 out of 120 bicycle injuries.
714 120
336 51
26
125 25
90
40%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
AUTO MOTORCYCLE BICYCLE
Protected Unprotected Unknown
n=1175 n=196 n=120
FY 2005
MCLNO Trauma Registry 20
EMERGENCY CENTER TRAUMA ADMISSIONSby Day of Week
n=3907n=3907
692
548490
528484
539
626
0
100
200
300
400
500
600
700
SUN MON TUE WED THU FRI SAT
DAY
Weekends remain the most active period, with Saturday, Sunday, and Monday accounting for 48% of the total weekly admissions. (Day
is 0800 to 0759.)
FY 2005
MCLNO Trauma Registry 21
EMERGENCY CENTER TRAUMA ADMISSIONSby Shiftn=3512n=3512
982
1603
1140
0
200
400
600
800
1000
1200
1400
1600
1800
0801 - 1600 1601 - 2400 0001 - 0800
SHIFT
The highest volume of trauma patients seen in the Emergency Department continued to be during the evening hours.
FY 2005
MCLNO Trauma Registry 22
EMERGENCY CENTER MAJOR TRAUMAPATIENT TURNAROUND TIME
(Number of Patients)
ADMITTO:
<90Minutes
90 – 179Minutes
180 – 269Minutes
>270Minutes
Total PatientsAverage Times
2003
2004
2005
2003
2004
2005
2003
2004
2005
2003
2004
2005
2003
2004
2005
Floor
19 30 27 33 25 23 40 26 16 554 538 494 634pts11.9hrs
627pts12.3hrs
560pts12.2hrs
ICU
15 14 23 19 24 15 16 17 18 310 354 323 310pts11.5hrs
404pts12.3hrs
379pts12.1hrs
OR
23 38 26 18 25 33 26 26 39 576 562 654 702pts12.2hrs
644pts12.8hrs
752pts12.5hrs
FY 2003-2005
MCLNO Trauma Registry 23
EMERGENCY DEPARTMENT DISPOSITION
n=3907n=3907
ADMITTED55%
Trans1%
Died3%
Home41%
Floor18%
OR21%
ICU10%
Stepdown 6%
Fifty-nine (59%) of admitted patients required intensive care or urgent operative care upon admission. Forty-one percent (41%) of patients were discharged to home from
the ED compared to Thirty-eight (38%) in FY 2004.
FY 2005
MCLNO Trauma Registry 24
ADMITTING SERVICEn=2209n=2209
1206
453
265
21867
Surgery
Orthopedic
Other Surgical
Neurosurgery
Non-Surgical
All major trauma patients are initially seen and evaluated by the Trauma Team. Once cleared for poly-trauma, consultation is obtained as appropriate. Orthopedics and neurosurgery remain
active in the care of these patients. “Other Surgical” reflects the involvement of plastic, urology, ENT, pediatric and oral surgery services.
FY 2005
MCLNO Trauma Registry 25
PROCEDURES ON TRAUMA PATIENTS
Number of ProceduresN=932
Number of ProceduresN=9,920
Total Patients(with Procedures)
n=3,083
O.R.44%
Other Loca-tions56%
Total Fatalities(with Procedures)
n=166
O.R.43%Other
Loca-tions57% Total Procedures
n=9,920
OR-Blunt28%
Other Locations
54%OR-
Penetrating18%
OR46%
There were 9,920 total procedures performed on 3,083 patients (79% of all trauma patients).
SURVIVORS = 3.2 avg. # procedures – FATALITIES = 5.6 avg. # procedures
FY 2005
MCLNO Trauma Registry 26
HEAD INJURYn=649n=649
Seventeen percent (17%) of trauma patients suffered head injuries, the majority being secondary to blunt trauma. Twenty-five (25%), or 161
patients, experienced disability or death.
Neurological Deficits
Death16%
w/ o Disability
75%with
Disability9%
I njury Category
Pene-trating12%
Blunt88%
FY 2005
MCLNO Trauma Registry27
SPINAL INJURYn=71n=71
Neurological Deficits
Death7%
w/ o Disability
52%
with Disability
41%
I njury Category
Penetrating25%
Blunt75%
One point eight percent (1.8%) of patients suffered spinal cord injury with 48% of these patients having disability or death. This represents
34 patients.
FY 2005
MCLNO Trauma Registry28
HOSPITAL DISCHARGE DISPOSITION
n=3907n=3907Expired
5%
Home80%
Rehab3%
AcuteCare3%
SNF/Resid.
3%Medical
9%
AMA3%
Non-Medical
3%
Home Expired AMA Non-Medical Acute Care SNF/ Resid. Rehab
Eighty-three percent (83%) of all patients were discharged home or left against medical advice; 363 (9%) were transferred to medical facilities.
FY 2005
MCLNO Trauma Registry29
EYE & ORGAN PROCUREMENTn=192 deathsn=192 deaths
A major contribution made by this trauma center’s patients is the “gift of life” through organ donation. Thirty-two patients were satisfactory
donors and 55 organs or tissue were recovered.
40
32
70
1310
0
10
20
30
40
50
60
70
80
DONOR REFERRALS ACTUAL DONORS
Organs Tissues Eyes
FY 2005
MCLNO Trauma Registry30
DRUG & ALCOHOL RESULTSFOR TRAUMA ACTIVATIONS
(BASED ON PERCENTAGE OF TESTED POPULATION)
33%30%
39%
27%
67%
58%
71%
25% 25% 23%
36%
64%
0%
10%
20%
30%
40%
50%
60%
70%
80%
ALL ACTIVATIONS BLUNT PENETRATING FATALITIES
Te
ste
d p
op
ula
tio
n w
ith
po
sti
ve
va
lue
s
Alcohol Only Drugs Only Alcohol & Drugs
n=
14
32
n=
11
18
n=
95
7
n=
93
6
n=
66
2
n=
81
7
n=
29
5
n=
51
n=
41
n=
33
n=
29
8
n=
49
6
FY 2005
MCLNO Trauma Registry31
REIMBURSEMENT SUMMARYn=3907n=3907
FY 2005 Payor Types
Medicaid14%
Medicare2%
Private9%
MAP15%
Free Care6%
Self Pay54%
The Trauma Center provides services for all patients regardless of payor status. Forty (40%) of patients have some form of payment assistance.
*Includes private insurance, worker’s compensation, HMO/PPO. MAP represents Medicaid Applied For.
2003 2004 2005
SelfPay
1794 1688 2105
*Private 261 340 345
MAP 1162 841 577
Medicare 68 102 92
Auto 7 56 15
Medicaid 463 556 533
Free Care
278 297 240
FY 2005
MCLNO Trauma Registry 32
FY 2005 SPREADSHEET COMPARISON
Slides 9-10
MCLNO Trauma Registry 33
FY 2003 FY 2004 FY 2005 FY 2003 FY 2004 FY 2005
PATIENT DEMOGRAPHICS Fatal Trauma 214 182 192
All Patients 4033 3880 3907 MORTALITY RATES 5.3% 4.7% 4.9%
RACE RACEBlack 2593 2427 2429 Black 160 111 109White 1289 1277 1288 White 51 58 73Asian 40 54 52 Asian 1 6 4Other 111 122 138 Other 3 7 6
AGE AGEPediatric 365 349 323 Pediatric 7 4 8Adult 3519 3405 3452 Adult 194 163 170Elderly 146 125 127 Elderly 14 15 14
GENDER GENDERMale 2992 2875 3005 Male 190 148 158Female 1040 1005 902 Female 25 34 34
FY 2005 SPREADSHEET COMPARISON
SLIDES 11-14
MCLNO Trauma Registry 34
FY 2003 FY 2004 FY 2005 FY 2003 FY 2004 FY 2005
PARISH OF INJURY VS RESIDENCE PATIENT TRIAGE SUMMARY
Parish of Injury TRUE + 724 759 909
ORLEANS 2033 2054 2089 TRUE - 94 74 97
JEFFERSON 136 175 302 OVERTRIAGE-- FALSE + 633 688 820
ST. BERNARD 60 58 58 UNDERTRIAGE-- FALSE - 250 218 266
WASH/ST. TAMMANY 26 33 66
PLAQUEMINES 34 27 26 MECHANISM OF INJURY
OTHER 87 124 133 Blunt 3027 2932 2808
UNKNOWN 1657 1409 1233 Penetrating 942 895 1099
Parish of Residence Burn 64 53 57
ORLEANS 2399 2224 2140
JEFFERSON 555 554 633 SEVERITY OF INJURY
ST. BERNARD 169 141 153 Minor Trauma 1816 1744 1650
WASH/ST. TAMMANY 110 181 205 Major Trauma 2217 2136 2257
PLAQUEMINES 82 71 35 FATAL 214 182 192
OTHER 534 521 560 NON-FATAL 2003 1954 2065
UNKNOWN 37 44 54
OUT OF STATE 147 144 127
MCLNO Trauma Registry 35
FY 2003 FY 2004 FY 2005 FY 2003 FY 2004 FY 2005
PATIENT TRANSPORTATION INJURY SEVERITY SCORE
SELF/FAMILY 702 700 583 Activated Patients
Admits & ED Deaths
POLICE 78 73 102 ISS 1-5
OTHER 23 27 15 Blunt 218 188 167
Prehospital Total Penetrating 157 111 154
EMERGENCY MEDICAL SERVICES 2606 2552 2623 ISS 6-10
NOHD 1974 1954 1897 Blunt 230 237 278
Lifeguard EMS 93 71 59 Penetrating 132 139 159
Guardian ~~~~ ~~~~ 24 ISS 11-15
Acadian EMS ~~~~ 51 142 Blunt 117 144 149
AMR 82 76 17 Penetrating 42 33 48
East Jefferson 95 116 128 ISS 16-20
West Jefferson 25 52 168 Blunt 109 130 118
Other EMS 125 125 114
Air EMS ~~~~ 39 74 Penetrating 80 49 54
Interhospital Total ISS 21-25
GROUND EMS 598 472 521 Blunt 79 90 86
Acadian EMS 298 239 300 Penetrating 49 42 54
Amed EMS ~~~~ 12 9 ISS >25
EmergyStat ~~~~ 36 23 Blunt 97 148 167
AMR 15 16 6 Penetrating 68 67 66
NOHD ~~~~ 45 51
Other EMS 220 110 112
AIR EMS 26 56 62
FY 2005 SPREADSHEET COMPARISON
SLIDES 15-16
MCLNO Trauma Registry
FY 2005 SPREADSHEET COMPARISON
SLIDES 17-19FY 2003 FY 2004 FY 2005 FY 2003 FY 2004 FY 2005
ETIOLOGY BY INTENT TRAUMA ACTIVATION LEVELS BY ISSAccidental 2754 2690 2559 Activated Patients - Admits & ED DeathsAssault 1156 1097 1229 ISS 1-5Self-Inflicted 73 50 51 Regular 283 218 220Undetermined 50 43 68 Partial 92 81 102
ISS 6-10
INTENTIONAL INJURIES Regular 279 287 315Self-Inflicted 43 41 39 Partial 83 89 122Versus Another 1155 1099 1257 ISS 11-15
FIREARM 539 511 628 Regular 121 124 144STABBING 276 261 309 Partial 38 53 54OTHER 340 327 320 ISS 16-20
Regular 154 152 134
VEHICULAR TRAUMA Partial 35 27 38Auto ISS 21-25
PROTECTED 674 718 714 Regular 112 119 116UNPROTECTED 419 311 336 Partial 16 13 24UNKNOWN /NA 124 139 125 ISS >25
Motorcycle Regular 154 202 208PROTECTED 59 79 120 Partial 11 13 25UNPROTECTED 74 101 51UNKNOWN 33 39 25
BicyclePROTECTED 3 1 4UNPROTECTED 18 32 26UNKNOWN 119 91 90
36
MCLNO Trauma Registry
FY 2005 SPREADSHEET COMPARISON
Slides 21-24
37
FY 2003 FY 2004 FY 2005 FY 2003 FY 2004 FY 2005
TRAUMA CENTER ARRIVALS BY DAY OF WEEK ED MAJOR TRAUMA PATIENT TURNAROUND TIMES
Monday 609 557 548 Floor AVERAGE TIME11.9hrs 12.3hrs 12.2hrs
Tuesday 512 483 490 <90 MINUTES 19 30 27
Wednesday 561 548 528 90 - 179 MINUTES 28 25 23
Thursday 546 550 484 180 - 269 MINUTES 40 26 16
Friday 540 545 539 >270 MINUTES 547 538 494
Saturday 637 630 626 ICU AVERAGE TIME11.5hrs 12.3hrs 12.1hrs
Sunday 628 567 692 <90 MINUTES 15 14 23
90 - 179 MINUTES 22 24 15
TRAUMA CENTER ARRIVAL BY SHIFT 180 - 269 MINUTES 16 17 18
0801 - 1600 971 967 982 >270 MINUTES 310 354 323
1601-2400 1585 1555 1603 OR AVERAGE TIME12.2hrs 12.8hrs 12.5hrs
0001-0800 1088 990 1140 <90 MINUTES 23 38 26
90 - 179 MINUTES 27 25 33
EMERGENCY DEPARTMENT DISPOSITION 180 - 269 MINUTES 26 26 39
Admitted 2328 2308 2184 >270 MINUTES 576 562 654
OR 717 702 834
ICU 366 404 385
STEPDOWN 272 230 246
FLOOR 973 972 719
Transferred 30 29 31
Died 148 79 100Home 1527 1464 1592
MCLNO Trauma Registry
FY 2005 SPREADSHEET COMPARISON
Slides 25-38
FY 2003 FY 2004 FY 2005 FY 2003 FY 2004
ADMITTING SERVICE HEAD INJURYSurgery 1040 1059 1206 Injury CategoryOrthopedic Surgery 681 696 453 BLUNT 534 563Neurosurgery 267 266 218 PENETRATING 78 74Other-Surgical 266 232 265 Neurological DeficitsNon-Surgical 83 68 67 WITHOUT DISABILITY 490 479
WITH DISABILITY 45 66
PROCEDURES ON TRAUMA PATIENTS DEATH 77 92
Total Procedures 10075 9316 9920
OR 3947 4277 4514 SPINAL INJURYBlunt 2590 2821 2779 Injury CategoryPenetrating 1357 1456 1735 BLUNT 36 49
OTHER LOCATIONS 6128 5039 5406 PENETRATING 18 8Neurological Deficits
Total Patients with Procedures 3149 3026 3083 WITHOUT DISABILITY 29 23OR 1452 1382 1371 WITH DISABILITY 20 31
OTHER LOCATIONS 1697 1644 1712 DEATH 5 3
Total Fatalities with Procedures 164 159 166OR 38 63 50
OTHER LOCATIONS 126 96 116
38
MCLNO Trauma Registry
FY 2005 SPREADSHEET COMPARISON
Slides 29-32
39
FY 2003 FY 2004 FY 2005 FY 2003 FY 2004 FY 2005
HOSPITAL DISCHARGE DISPOSITION DRUG & ALCOHOL RESULTS FOR TRAUMA ACTIVATIONSMedical All Activations +/Tested +/Tested +/Tested
ACUTE CARE 98 99 122 ALCOHOL ONLY 703/2221 424/1543 469/1432REHAB FACILITY 165 131 129 DRUG ONLY 795/1522 609/854 612/957SNF/RESIDENTIAL 28 69 112 ALCOHOL & DRUG 275/765 260/843 275/1118
Non-Medical 59 87 122 BluntAMA 138 123 128 ALCOHOL ONLY 499/1615 289/1071 277/936Expired 214 182 192 DRUG ONLY 555/1143 436/628 441/662Home 3331 3189 3102 ALCOHOL & DRUG 201/602 197/671 207/817
Penetrating
EYE & ORGAN PROCUREMENT ALCOHOL ONLY 204/606 135/472 192/496Donor Referrals 57 116 110 DRUG ONLY 240/379 173/226 171/295
ORGANS 14 33 40 ALCOHOL & DRUG 74/163 63/172 68/298TISSUES 43 83 70 Fatals
ALCOHOL ONLY 9/51 14/57 14/51Actual Donors 13 24 55 DRUG ONLY 24/42 34/41 29/41
ORGANS 7 13 32 ALCOHOL & DRUG 4/19 11/35 12/33TISSUES 5 6 13EYES 1 5 10
REIMBURSEMENTPrivate 261 340 345Medicare 68 102 92Medicaid 463 556 533Auto 7 56 15MAP 1162 841 577Free Care 278 297 240Self-Pay 1794 1688 2105