People who live in rural areas suffer a significantly greater risk that they’ll die from an accident — even from something as simple as a fall.
That’s why Payson Regional Medical Center has invested in an upgrade of its emergency room, Director of Emergency Services Carl Valenti told the Payson Town Council in a high-energy presentation last week.
“Survival in a big-city trauma center is just much greater. Sixty percent of deaths from trauma occur in rural areas — although people living in rural areas account for only 20 percent of the population,” said Valenti.
The rate of injury-related deaths in rural areas is 40 percent higher than in urban areas.
Mostly, that’s because it takes longer to get to people who suffer trauma in rural areas — and then longer again to get them to comprehensive treatment.
“It’s really about speed — the discovery, getting help. I’m amazed at the stoicism in our community — with people driving themselves to the hospital in a decimated state,” said Valenti.
The hospital has increased its certification to provide a higher level of care, which means that emergency crews can divert more patients to the hospital from accidents, falls and other problems.
The medical center has emergency room doctors who communicate with the emergency crews in the field, providing guidance for the paramedics attempting to stabilize and assess patients.
Valenti said the hospital has an alarm system that can immediately alert a surgical team and other specialists to stand by even before a patient arrives.
The goal is to provide treatment — even surgery — within the “golden hour” after the initial injury. Emergency medical systems are designed to get definitive treatment for trauma victims within that first hour.
Despite the upgrade, the medical center still doesn’t rank as a full-fledged trauma center. The rules for such trauma centers would require the hospital to have expensive contracts with a host of specialists like heart surgeons, brain surgeons, bone surgeons and others, who would either work shifts in the hospital or agree to come when called within minutes at any time of the day or night.
Such around-the-clock access to surgical and other specialists can cost millions, which means that even in urban areas with a high volume of patients many full trauma centers struggle to make money.
The highest rating for a trauma center is Level 1. Payson is now a Level 4.
However, PRMC can now handle a wider range of trauma cases and can also stabilize patients before transferring them by helicopter to a Valley trauma center with a broader range of specialists.
The upgraded services fill a critical gap in a rural area, especially a town like Payson with a large retired population.
“We fall down a lot here,” said Valenti, “and those falls are really bad.”
Trauma remains the No. 4 cause of death nationally and the No. 1 cause of death in children and young adults. Trauma is the fifth leading cause of death among the elderly.
Valenti said the hospital has increased training and certification for all its emergency room workers. Moreover, almost the entire nursing and medical staff lives in Payson, a big improvement over a few years ago when many of the nurses commuted up from the Valley, said Valenti.
Payson Mayor Kenny Evans, on the board of the Mogollon Health Alliance, which actually owns the hospital, interjected, “Ninety percent of the trauma deaths among children occur before they make it to the hospital.”
“When the paramedics call us on the radio, they say put together the trauma team — so we’ve saved all that time when they hit the door. It’s kicking.”
“This isn’t your grandfather’s hospital,” quipped Evans.
“And we’re not done yet,” said Valenti. “We’ve got lots to do.”