Only THREE Trauma Centers in Kentucky...what a disgrace (Lexington: 2011, layoffs)

[kentuckydad95]

There was a story somewhere (that I can't seem to find) where our new Lt. Gov is pushing for more trauma centers, especially in far western KY. If someone has that story link, I would appreciate it.

In the western part of KY, I am not sure what would constitue lifting someone to Louisville when they have a large level I in Nashville. I may be wrong, but in the JP, you could get lifted to St Louis faster than L'ville.

[Hey_Hey]

I'm originally from Marshall County and within 15 minutes of Paducah, and I'm currently finishing up medical school in Ohio. I will be training in Emergency Medicine for residency starting next year. The trauma system in Kentucky is horrendous. I'm in school in Toledo right now, and we have THREE level I trauma centers in the city alone. That's more level I trauma centers than the entire state of Kentucky (I would actually argue Toledo has too many trauma centers, but that's a discussion for another day).

First off, the Level III designation probably doesn't mean a whole lot. They've been given a designation, but Level IIIs ship almost 100% of their traumas out to level IIs or Is. Level IIs could probably handle 90% of all traumas, and level Is can handle 100% of traumas. Also, just because a hospital (say Western Baptist in Paducah) doesn't have its designation as a trauma center doesn't mean they can't handle traumas.....it just means they typically don't handle them.

Realistically, only Louisville and Lexington will have Level I trauma centers because level I trauma centers rely on the cheap labor of freshly minted MDs to get the job done 24/7/365. Those two cities are the only places that have emergency medicine/surgery/neurosurgery/etc residents.

However, cities like Paducah, Bowling Green, Owensboro, and Ashland all probably have the resources to have a level II trauma center. For example, I know that Paducah already has the pieces in place to have a level II center (you basically need emergency medicine docs and surgical specialists like general surgeons, neurosurgeons, orthopedists, urologists, cardiothoracic surgeons, vascular surgeons, and plastic surgeons in addition to ICUs), but the organization and money isn't there to make it happen. They essentially already have all the specialists in place, but there isn't that funding source that will reimburse physicians for the additional liability, hours, and call time that is necessary (if you expect someone to be in the hospital overnight then you have to reimburse them for that time). Traumas are also very disruptive to the day's schedule and they tend to make scheduled patients very angry (they hate that their gallbladder surgery is postponed three hours).

Paducah definitely needs a level II trauma center. If they had one they would serve as the trauma center for the Purchas Area plus extreme southern illinois, a bit of SE Missouri, and a couple counties in NW Tennessee. That's plenty of area and population to support a level II center. For something shocking, look at Lima, OH, where there are TWO level II trauma centers. Lima is very similar in size to Paducah (but Paducah may actually serve a larger healthcare population since Toledo, Fort Wayne, and Dayton are all within 1.5 hours of Lima).

I really don't think it would take all that much money to get a trauma system setup in kentucky. Maybe $20 million up front and $5-10 million per year. Those are just guesses, but the infrastructure is already there (helicopters, helipads, and in large part physicians). Liability coverage will need to be covered at the beginning, and state reimbursement for uninsured patients will be needed as well as a funding source for on-call nights for the surgeons and operating room staff.

I would maintain UofL and UK as the Level I trauma centers. I would then add one of the Paducah hospitals and a Bowling Green Hospital as level IIs. If there are resources available I would add level IIs to Pikeville and London (I'm not sure what their capabilities are at this point), and if there are not resources available I would work to get the resources in place over the next 5 years. The Owensboro/Madisonville/Henderson area is well covered by Evansville. Ashland area would be covered by Huntington, WV (I believe they have a trauma center there). SE Kentucky is the one question mark. I'm not sure what that area has in regards to neurosurgeons, cardiothroacic surgeons, etc.

[kentuckydad95]

Excellent post!!! I agree 100%. Western Baptist has to have one of the largest emergency departments I have seen outside of a major city. I just don't see Lourdes becoming a trauma center. Here is the shocking number I was looking for:

Population within a 60-mile radius of Paducah- 479,273

Nah!!! I guess the Paducah area just ain't large enough. And as far as the money, I think the cost is well worth it if you can get patients the help they need within that "golden hour". The problem is getting our jack-booted-thug politicians to come up with they money. Where is that new 1.5 cents gas tax going? Let me guess; roads and schools aka: someone's pocket. I would like for WPSD to do a story, but that will be hard. They are more worried about the quilt show. With all the breaking news coming from WPSD in the past three weeks, you would think they are trying to land the olympics.

The Jackson Purchase NEEDS a trauma center!!!

[dixiegirl7]

Being from southern Kentucky I am thankful to be so close to Vanderbilt. We have helicopters at both hospitals plus a private service or two. I can see that this is a big issue in far Western Kentucky and it seems it would be for far southeastern Kentucky also. When I googled this I saw several studies and presentations various emergency doctors and administrators had written in the past to back up the need.

[kentuckydad95]

I am sorry to keep rambling, but it just irks me. The family and I drove to Paducah today and used the Purchase Parkway as one of the roads to get there from Murray. We noticed they had finished resurfacing all lanes in both directions to Draffenville and they are getting ready to finish the rest of the road from D'ville to Calvert City soon. Brand new guard-rails also along the new surface.

The road was in good shape to begin with. US 641 is falling apart, they won't (and refuse) to finish KY 80, but they spend MILLIONS on resurfacing a road that didn't really need it.

The point is, this state spends money bass-ackwards. At least they do on this end of the state. The people in SE KY are in the same boat. They can be thankful they have Knoxville or Lexington, but they need a trauma center too. If Lt. Dan gets anything done in his term, it needs to be this.

[Hey_Hey]

Originally Posted by kentuckydad95

I am sorry to keep rambling, but it just irks me. The family and I drove to Paducah today and used the Purchase Parkway as one of the roads to get there from Murray. We noticed they had finished resurfacing all lanes in both directions to Draffenville and they are getting ready to finish the rest of the road from D'ville to Calvert City soon. Brand new guard-rails also along the new surface.

The road was in good shape to begin with. US 641 is falling apart, they won't (and refuse) to finish KY 80, but they spend MILLIONS on resurfacing a road that didn't really need it.

The point is, this state spends money bass-ackwards. At least they do on this end of the state. The people in SE KY are in the same boat. They can be thankful they have Knoxville or Lexington, but they need a trauma center too. If Lt. Dan gets anything done in his term, it needs to be this.

I believe that is because the state is upgrading the Jackson Purchase Parkway to interstate standards in anticipation of I-69 opening in the next few years.

I also heard from a very reliable person that there will be a designated Level II trauma center in Paducah in the next 1-2 years. The state legislature has authorized the hiring of a director for a statewide trauma center. Unfortunately no funding is involved this year, but that will hopefully change soon.

[kentuckydad95]

Originally Posted by Hey_Hey

I believe that is because the state is upgrading the Jackson Purchase Parkway to interstate standards in anticipation of I-69 opening in the next few years.

I also heard from a very reliable person that there will be a designated Level II trauma center in Paducah in the next 1-2 years. The state legislature has authorized the hiring of a director for a statewide trauma center. Unfortunately no funding is involved this year, but that will hopefully change soon.

That is wonderful news about the trauma center. The I-69 issue is another bag of cats. The median in between lanes is way too narrow to be up to interstate standards. You can see the difference when you get off the PP and on I-24. The median is much wider. They would have to completely overhaul the PP to get it up to interstate standards. I believe, however I-69 in KY will fall along the lines of I-66 in KY...they ain't never gonna happen.

[Hey_Hey]

Signs will actually be going up along Western Kentucky Parkway and Pennyrile Parkways this summer designating them as I-69. This was after HR-1195 was signed into law a few weeks ago by President Bush. I don't know when to expect signs to go up on Jackson Purchase Pkwy.

[stx12499]

Originally Posted by Hey_Hey

Signs will actually be going up along Western Kentucky Parkway and Pennyrile Parkways this summer designating them as I-69. This was after HR-1195 was signed into law a few weeks ago by President Bush. I don't know when to expect signs to go up on Jackson Purchase Pkwy.

This doesnt make sense. I-69 ends in Indianapolis, and it is suppossed to get extended from Indy to Evansville, but it is not built yet...so how will this work?

[timelesschild]

Originally Posted by kentuckydad95

The Jackson Purchase NEEDS a trauma center!!!

So get one going, Kentuckydad. You know the need, you know the costs, now all you need is a grantwriter and a legislative lobbyist. Do it - be a hero for your region.