SPECIAL REPORT: Trauma care in the borderland

When a loved one is in a life-or-death situation, getting the best care is the number-one priority. For Borderland patients, that may very well mean traveling across state lines.

“The faster you get somebody to a care facility, for definitive care, means you will hopefully save their life,” said Dr. Alan Tyroch, Chief Trauma Surgeon at University Medical Center.

Dr. Tyroch added when it comes to his patients, every second counts. “If we weren’t here, there would be some patients that would’ve died,” Dr. Tyroch said.

UMC is the only level-one trauma center in the borderland, meaning its team of trauma surgeons is required to be on call 24/7. Over the past 20 years, Dr. Tyroch has spent 1,300 nights at the hospital.

“Trauma is a team sport, that’s one thing I’ll always emphasize,” Dr. Tyroch said.

Last year, UMC saw more than 3,000 trauma patients, many of them airlifted from all over the area. UMC receives patients from El Paso, Hudpseth, and Culberson county, and Southern New Mexico.

“We do receive patients officially from Southern New Mexico, because we’re a lot closer than Albuquerque is,” Dr. Tyroch said.

Patients are often transported between El Paso hospitals depending on the level of trauma care need. Many are airlifted from outside areas to El Paso hospitals like Del Sol Medical Center, which is a level-two trauma center. Liana Lujan, with the New Mexico Department of Health said the majority of patients are transported to UMC because it is a level one trauma center.

“In 2005, we had the State of New Mexico hire some folks to come in and do an assessment of the trauma system in New Mexico. We didn’t have one. We knew there was a huge need in New Mexico for trauma centers. One of the highest needs that they identified, was in Las Cruces,” Liana Lujan, Trauma Manager for the New Mexico Department of Health said.

There are four different levels of trauma centers. A level one trauma center has 24/7 trauma and specialty care available for all services, participates in clinical research on trauma care and has residents training in trauma. A level two trauma center has 24/7 trauma and specialty care available for all services. A level three trauma center has 24/7 trauma and some specialty care services available. A level four trauma center has an Emergency Department with trauma team activation and can rapidly facilitate transport to a higher level of care if necessary.

The process to becoming a trauma center lasts two years and depending on the level, can be a major commitment.

“The first year is all about building the program itself. The second year is acting like a trauma center. You can’t be a trauma center, you can’t call yourself a trauma center, but you should have been working with your pre-hospital providers, you should have been instituting transfer guidelines for specialty services for that one year and now you need to implement all those things you need to build,” Lujan said.

Lujan tells ABC-7 up until recently, neither of Las Cruces’ two hospitals pursued accreditation.

“While I understand that, it took resources what that did was it took patients and families out of the community to be treated at UMC in El Paso and not necessarily needing a level one trauma care. So we’ve worked very closely with MountainView,” Lujan said.

“Trauma is a process. It’s a process, it’s a lot of work, and I think it’s something definitely needed in our region,” Kelly Clark, Chief Nursing Officer at MountainView Regional Medical Center said.

Clark tells ABC-7 MountainView has worked two years toward getting its accreditation as a level three trauma center.

“We’ve added multiple staff members to get ready as part of our process of developing a trauma facility. There are requirements for that as well so we’ve added additional staff and a trauma coordinator, who’s a full-time trauma coordinator and full-time trauma registrar as well that are dedicated only to the development of the trauma process. Additionally, we’re creating additional trauma surgeons to the area,” Clark told ABC-7.

Across town at Memorial Medical Center, CEO John Harris tells ABC-7 it’s only a matter of time until they pursue theirs again.

“I think very closely we’ll move to a level four and very shortly thereafter move to a level three,” Harris said.

Memorial Medical Center submitted its letter of intent to become a trauma center, but withdrew this year. Harris says they may soon apply for theirs again. He says the commitment is not so much a financial burden.

“For us it’s more organizational, it’s more management in terms of how we direct these services responsibly. The investment that it will take to do this is not really the paramount issue. It’s really doing it responsibly in a quality safe environment,” Harris said.

Lujan says one hospital’s trauma designation doesn’t necessarily impact another hospital financially. She says because of the borderland’s unique needs, the more trauma care available, the better.

“If your injuries are not severe enough, to warrant a level one and you can be treated at the nearest, closest level three, it benefits that patients and it helps UMC El Paso focus on those higher level needs,” Lujan said.

“Having others develop in that capacity is not really a threat. It really is about providing safe quality care to the patients to the region,” Harris said.

Clark adds Las Cruces relies heavily on El Paso hospitals.

“As much as taking care of patients at home some patients require a higher level of care that’s not available here. It’s working closely with the El Paso trauma centers, assures that that’s available to them on any level,” Clark said.

“Trauma does not think about borders. You want to have a good trauma systems and that’s what we have. We have a level two with Del Sol downt the street there we have two level threes in the center, in the city, and the other hospitals are level fours. So they all support each other asnd support us as the level one and the same thing with New Mexico.”

MountainView could not say if and when they anticipate getting accredited. However, Lujan tells ABC-7 the hospital had a successful verification site visit two weeks ago and says she’s waiting for the report to give her recommendation to Secretary of Health.