The Birmingham News
Pandemic fears trouble already struggling ERs
From staff and wire reports
Trauma centers and emergency departments are strained in many U.S. cities, experts say, and hospitals are ill-prepared to handle a disaster, The Associated Press reported Sunday. "Trauma systems are never more than a couple of minor incidents from being overwhelmed," said Larry Gage, president of the National Association of Public Hospitals and Health Systems.
But that’s not the case in Birmingham, where local emergency medical personnel say the Birmingham Regional Emergency Medical Services System makes this area much better prepared for a mass casualty incident disaster than many larger cities.
"Atlanta and others don't have real-time routing," said BREMSS director Joe Acker. The Birmingham system links 18 hospitals in Jefferson, Blount, Shelby, St. Clair, Walker and Chilton counties. When Acker checked activity Sunday at Birmingham-area emergency rooms, he found out within seconds that three hospitals were full at 5: 15 p.m.
All emergency workers in the region have access to the same information as Acker, meaning paramedics quickly find space for patients in one of the other 15 hospitals linked to a computerized system. Acker said this real-time communications system gives the metro area an advantage over places such as Atlanta.
"Our resources get tight at times, but at this time we've never had a situation where we could not find a patient an available ER bed or an available ICU bed," he said.
Paramedics consult the system and it tells them, using red, green or yellow lights, which hospitals can take trauma and stroke patients. When trauma centers such as UAB or Children's Hospital get overloaded, a mechanism automatically re-routes patients to other hospitals.
On average, up to 20 trauma patients are diverted each day. Acker said the volume of patients in need of emergency room services has definitely increased in the area over the last five to eight years. Just last year, for example, the system saw 2,800 tram patients, a number that is expected to reach 3,200 this year. He attributes the increase to a variety of things, including large numbers of people who don't have primary care physicians, known as unattached patients, but not necessarily uninsured. Also, people are staying active as they get older.
The Associated Press story focused on Atlanta's main trauma hospital, where lines of waiting patients clog the hallways even on slow days. Doctors say they probably couldn't handle a major plane crash or any other incident with more than 20 or 30 severe injuries.
"It's a struggle to meet the nightly demand of 911 calls," said Dr. Arthur Kellermann, an ER physician at the hospital, Grady Memorial. "But somehow we're supposed to deal with a . .. terrorist bombing? Or a new strain of influenza?"
Hurricane Katrina destroyed New Orleans' only trauma center. A few years ago, funding problems nearly closed primary trauma centers in Detroit and Los Angeles, and more than a dozen other U.S. hospitals have phased down or shuttered their trauma units since. That trend, along with a growing U.S. population, is making it harder for many hospitals to quickly and adequately handle severe emergencies.
Across the country, the level of crowding at emergency departments has reached levels that are unprecedented in America's history, said Dr. Kathleen Clem, chief of emergency medicine at Duke University Medical Center.