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Driving down I-69 just miles from Muncie headed to Indianapolis, a car flips over the median and crashes into an oncoming vehicle.
In one car is a 5-year-old girl, severely injured, and her 57-year-old grandfather with an open fracture and bleeding. In the other car is a 23-year-old woman, who was ejected and has a traumatic brain injury.
It’s a devastating scene, but all their chances of survival – before any ambulance or helicopter even arrived – just catapulted.
All these people will be treated within the IU Health trauma system – one of the most comprehensive in the nation. When patients are treated at certified trauma centers, their chances of survival jump. At Level I centers, survival rates increase 25 percent.
Ultimately, the little girl will land at Riley Hospital for Children at IU Health – a Level I pediatric trauma center. The grandfather will be at IU Health Ball Memorial Hospital – a Level III trauma center.
And the young woman will be airlifted by IU Health’s own LifeLine helicopter to IU Health Methodist Hospital – a Level I trauma center and one of the 15 busiest in the nation.
All the while, in every ambulance, helicopter, hospital and trauma center, the protocols will be the same. The guidelines on getting antibiotics to patients in minutes and stopping the bleed to prevent hemorrhaging will be the same. Records can be transferred seamlessly from Ball to Methodist or Riley, if need be -- all are on the same system.
“It’s a well-orchestrated ballet. You have all these people doing their part, coming together,” says Bekah Dillon, director of operations for trauma, the emergency department and Center of Hope at Ball Memorial, which has been verified Level III since 2014. “It’s a completely different level of care.”
Completely different is right.
IU Health’s system, including five trauma centers, air and ground transport and comprehensive injury prevention and education – is believed to be a rarity nationwide.
“We are the only one in the country with this many trauma centers in the system,” says Missy Hockaday, a trauma nurse practitioner who is service line director for trauma and acute care surgery at IU Health. “It’s very unique. I’m not aware of any trauma system this comprehensive anywhere else.”
A trauma system is the entire cycle of care -- from injury prevention, to pre-hospital, to hospital, to trauma center (if needed), to rehabilitation and then back home to injury prevention.
Besides the three trauma centers Methodist, Riley and Ball Memorial, two other Level III trauma centers are in the system -- IU Health Arnett and Bloomington hospitals. All are American College of Surgeons certified.
“We are doing injury prevention strategy as a system. We are doing education as a system,” Hockaday says. “From the time of injury, we are making sure they get to the right place at the right time. This is all about patient care.”
At Bloomington, which was verified Level III nearly a year ago, the volume of trauma patients has increased by 15 percent.
“Having this trauma system has been huge at Bloomington,” says Lindsey Williams, the trauma program manager and a nurse practitioner. “Being able to activate the appropriate team, get all hands on board immediately. We are utilizing a proactive approach rather than a reactive one.”
And all the hospitals have their big brother Methodist to count on, as well as LifeLine on the ground and in the air.
“We have the Level 1 resources basically at our fingertips,” says Amanda Rardon, trauma program manager for the west central region, including Arnett, which was first verified Level III in 2014. “It’s unprecedented. It’s a seamless transfer process. All of our records are together. We are all working together.”
For Dillon at Ball Memorial, becoming a verified trauma center has elevated the level of care for all patients.
“There is the collaboration with Methodist,” she says. “I’m a phone call away from some of the best trauma surgeons and trauma team in the nation. I have them on speed dial.”