Las Vegas Faced a Massacre. Did It Have Enough Trauma Centers?
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Vegas Mourns After Largest Mass Shooting In U.S. History","publishDate":1507161536,"status":"inherit","parent":361338,"modified":1507161761,"caption":"Matthew Helms, who worked as a medic the night of the shooting, visits a makeshift memorial for the victims of Sunday night's mass shooting.","credit":"Drew Angerer/Getty Images","description":"Matthew Helms, who worked as a medic the night of the shooting, visits a makeshift memorial for the victims of Sunday night's mass 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Did It Have Enough Trauma Centers?","publishDate":1507161814,"format":"standard","headTitle":"Kaiser Health News | State of Health | KQED News","labelTerm":{"term":3007,"site":"stateofhealth"},"content":"\u003cp>Las Vegas is not only a glittering strip of casinos and hotels but a fast-growing region with more than 2 million residents — and one hospital designated as a highest-level trauma center.\u003c/p>\n\u003cp>The deadly shooting Sunday that killed at least 59 and sent more than 500 people to area hospitals raised questions about whether that’s enough.\u003c/p>\n\u003cp>Las Vegas is not the only big city with just one such trauma center. Seattle and Nashville, among others, also are in \u003ca href=\"http://www.amtrauma.org/?page=FindTraumaCenter\" target=\"_blank\" rel=\"noopener\">this category\u003c/a>, according to the American Trauma Society, a professional and advocacy organization focused on improving trauma care.\u003c/p>\n\u003cp>Casey Nolan, a hospital consultant and managing director of Navigant Consulting in Washington, D.C., said what matters most is not the number of high-level centers, but the degrees of coordination across the area’s medical network, including the first responders.\u003c/p>\n\u003cp>“It’s how well integrated the care is and whether there is a triage system to get patients to the right place in the right time,” he said.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cstrong>What Makes Up The Network\u003c/strong>\u003c/p>\n\u003cp>The highest-level trauma centers are equipped and staffed around-the-clock to provide care for patients who suffer from traumatic injuries such as gunshot wounds, falls and car accidents.\u003c/p>\n\u003cp>The designation “trauma center” is the result of a validation process at the state or local level. Centers are categorized by Level I, II or III, for instance, in keeping with nationally accepted standards. Centers can also seek additional approval from the American College of Surgeons.\u003c/p>\n\u003cp>Across the country, there are \u003ca href=\"http://www.amtrauma.org/?page=FindTraumaCenters.\" target=\"_blank\" rel=\"noopener\">217 Level I trauma centers\u003c/a>, up from 198 in 2012, according to the trauma society. These centers must see at least 1,200 trauma patients a year and have general surgeons and other specialists immediately available at the facility.\u003c/p>\n\u003cp>There are another 310 Level II centers that face similar staffing rules, but with fewer education and training requirements. Level III centers have emergency medical staff, but will stabilize severely injured patients and often transport them to higher-level trauma centers.\u003c/p>\n\u003cp>For decades, the hospital industry viewed trauma care as a money-losing proposition because of the high costs of keeping doctors and nurses on standby 24 hours a day. Trauma centers, particularly those in inner cities, tended to attract more patients without health insurance.\u003c/p>\n\u003cp>But in recent years, hospitals have been competing to get the designation as a way to increase profits, in part because trauma centers enhance demand for surgery and ancillary services like CT scans. In addition, a trauma designation can boost a facility’s overall reputation, Nolan added.\u003c/p>\n\u003cp>“Trauma had gotten a bad rap,” explained Nolan. “But in suburban locations, where more people have insurance, you can do pretty well on trauma.”\u003c/p>\n\u003cp>Some hospitals also began charging a fee — known as a “trauma activation” fee — to help pay for the extra staffing and equipment trauma units require.\u003c/p>\n\u003cp>Those fees could range from a few hundred dollars to several thousand dollars on patients’ bills, Nolan said.\u003c/p>\n\u003cp>\u003cstrong>Trauma Care In Las Vegas\u003c/strong>\u003c/p>\n\u003cp>Despite the burgeoning population of Las Vegas and surrounding Clark County, which more than doubled to 2.2 million in the past 25 years, University Medical Center has been Las Vegas’ only Level I trauma center since 1992.\u003c/p>\n\u003cp>The metro area includes two other lower-level trauma centers. Sunrise Hospital & Medical Center in Las Vegas is a Level II facility and St. Rose Dominican Hospital in nearby Henderson, Nev., is a Level III.\u003c/p>\n\u003cp>Even the idea of expanding Las Vegas’ trauma network has stirred controversy.\u003c/p>\n\u003cp>Last year, a state agency rejected applications by three hospitals in the Las Vegas area to be designated as Level III trauma centers.\u003c/p>\n\u003cp>HCA, the national, for-profit chain that owned two of these facilities, said adding trauma centers would help ensure quicker care to patients in the growing region. The company has made adding trauma centers a strategy across the country and has met resistance from existing centers.\u003c/p>\n\u003cp>But opponents argued HCA was motivated by the opportunity to boost profits. The \u003ca href=\"http://www.tampabay.com/news/health/how-hca-turned-trauma-into-a-money-maker/2169280\" target=\"_blank\" rel=\"noopener\">Tampa Bay Times\u003c/a> reported last year that the hospital chain charged significantly higher “activation fees” than other hospitals.\u003c/p>\n\u003cp>Opponents also countered that adding trauma centers would affect University Medical Center’s ability to provide quality care and train doctors. Some experts say it could diminish the number of patients seen at each center.\u003c/p>\n\u003cp>That’s because the more trauma patients a center deals with annually, the better the results, studies show.\u003c/p>\n\u003cp>“If you can bring all the patients to one place, then those surgeons become really good at dealing with trauma, instead of spreading it out [around a number of facilities],” said Bill Bullard, senior vice president with the Abaris Group, a California-based consulting firm that advises hospitals on emergency care.\u003c/p>\n\u003cp>Ian Weston, executive director of the American Trauma Society, said the trauma system worked well in Las Vegas, which is a credit to ambulances and other first responders and their ability to triage patients to hospitals across the city.\u003c/p>\n\u003cp>Seriously ill patients have the best outcomes when treated at a Level I trauma center, said David Callaway, a professor of emergency medicine at the Carolinas Medical Center in Charlotte, N.C. But “when you have 500-plus casualties and 58 dead … if all the patients went to a Level I, mortality would not be improved, because they would be completely overwhelmed,” Callaway added.\u003c/p>\n\u003cp>Bullard agreed.\u003c/p>\n\u003cp>“In theory, the more centers you have the more people you have to deal with injuries. However, no trauma system is able to handle a tragedy of this magnitude.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>\u003ca href=\"http://www.kaiserhealthnews.org/\">Kaiser Health News\u003c/a> (KHN) is a national health policy news service. It is an editorially independent program of the \u003ca href=\"http://www.kff.org/\">Henry J. Kaiser Family Foundation\u003c/a>.\u003c/em>\u003c/p>\n\n","blocks":[],"excerpt":"Hospitals view adding trauma care as a potential profit tool, but experts say more centers don't necessarily improve the system’s ability to respond to a mass casualty event.","status":"publish","parent":0,"modified":1507161814,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":32,"wordCount":978},"headData":{"title":"Las Vegas Faced a Massacre. Did It Have Enough Trauma Centers? | KQED","description":"Hospitals view adding trauma care as a potential profit tool, but experts say more centers don't necessarily improve the system’s ability to respond to a mass casualty event.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Las Vegas Faced a Massacre. Did It Have Enough Trauma Centers?","datePublished":"2017-10-05T00:03:34.000Z","dateModified":"2017-10-05T00:03:34.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"361338 https://ww2.kqed.org/stateofhealth/?p=361338","disqusUrl":"https://ww2.kqed.org/stateofhealth/2017/10/04/las-vegas-faced-a-massacre-did-it-have-enough-trauma-centers/","disqusTitle":"Las Vegas Faced a Massacre. Did It Have Enough Trauma Centers?","nprByline":"\u003ca href=\"https://khn.org/news/author/julie-appleby/\">Julie Appleby\u003c/a> and \u003ca href=\"https://khn.org/news/author/phil-galewitz/\">Phil Galewitz\u003c/a>","path":"/stateofhealth/361338/las-vegas-faced-a-massacre-did-it-have-enough-trauma-centers","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Las Vegas is not only a glittering strip of casinos and hotels but a fast-growing region with more than 2 million residents — and one hospital designated as a highest-level trauma center.\u003c/p>\n\u003cp>The deadly shooting Sunday that killed at least 59 and sent more than 500 people to area hospitals raised questions about whether that’s enough.\u003c/p>\n\u003cp>Las Vegas is not the only big city with just one such trauma center. Seattle and Nashville, among others, also are in \u003ca href=\"http://www.amtrauma.org/?page=FindTraumaCenter\" target=\"_blank\" rel=\"noopener\">this category\u003c/a>, according to the American Trauma Society, a professional and advocacy organization focused on improving trauma care.\u003c/p>\n\u003cp>Casey Nolan, a hospital consultant and managing director of Navigant Consulting in Washington, D.C., said what matters most is not the number of high-level centers, but the degrees of coordination across the area’s medical network, including the first responders.\u003c/p>\n\u003cp>“It’s how well integrated the care is and whether there is a triage system to get patients to the right place in the right time,” he said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cstrong>What Makes Up The Network\u003c/strong>\u003c/p>\n\u003cp>The highest-level trauma centers are equipped and staffed around-the-clock to provide care for patients who suffer from traumatic injuries such as gunshot wounds, falls and car accidents.\u003c/p>\n\u003cp>The designation “trauma center” is the result of a validation process at the state or local level. Centers are categorized by Level I, II or III, for instance, in keeping with nationally accepted standards. Centers can also seek additional approval from the American College of Surgeons.\u003c/p>\n\u003cp>Across the country, there are \u003ca href=\"http://www.amtrauma.org/?page=FindTraumaCenters.\" target=\"_blank\" rel=\"noopener\">217 Level I trauma centers\u003c/a>, up from 198 in 2012, according to the trauma society. These centers must see at least 1,200 trauma patients a year and have general surgeons and other specialists immediately available at the facility.\u003c/p>\n\u003cp>There are another 310 Level II centers that face similar staffing rules, but with fewer education and training requirements. Level III centers have emergency medical staff, but will stabilize severely injured patients and often transport them to higher-level trauma centers.\u003c/p>\n\u003cp>For decades, the hospital industry viewed trauma care as a money-losing proposition because of the high costs of keeping doctors and nurses on standby 24 hours a day. Trauma centers, particularly those in inner cities, tended to attract more patients without health insurance.\u003c/p>\n\u003cp>But in recent years, hospitals have been competing to get the designation as a way to increase profits, in part because trauma centers enhance demand for surgery and ancillary services like CT scans. In addition, a trauma designation can boost a facility’s overall reputation, Nolan added.\u003c/p>\n\u003cp>“Trauma had gotten a bad rap,” explained Nolan. “But in suburban locations, where more people have insurance, you can do pretty well on trauma.”\u003c/p>\n\u003cp>Some hospitals also began charging a fee — known as a “trauma activation” fee — to help pay for the extra staffing and equipment trauma units require.\u003c/p>\n\u003cp>Those fees could range from a few hundred dollars to several thousand dollars on patients’ bills, Nolan said.\u003c/p>\n\u003cp>\u003cstrong>Trauma Care In Las Vegas\u003c/strong>\u003c/p>\n\u003cp>Despite the burgeoning population of Las Vegas and surrounding Clark County, which more than doubled to 2.2 million in the past 25 years, University Medical Center has been Las Vegas’ only Level I trauma center since 1992.\u003c/p>\n\u003cp>The metro area includes two other lower-level trauma centers. Sunrise Hospital & Medical Center in Las Vegas is a Level II facility and St. Rose Dominican Hospital in nearby Henderson, Nev., is a Level III.\u003c/p>\n\u003cp>Even the idea of expanding Las Vegas’ trauma network has stirred controversy.\u003c/p>\n\u003cp>Last year, a state agency rejected applications by three hospitals in the Las Vegas area to be designated as Level III trauma centers.\u003c/p>\n\u003cp>HCA, the national, for-profit chain that owned two of these facilities, said adding trauma centers would help ensure quicker care to patients in the growing region. The company has made adding trauma centers a strategy across the country and has met resistance from existing centers.\u003c/p>\n\u003cp>But opponents argued HCA was motivated by the opportunity to boost profits. The \u003ca href=\"http://www.tampabay.com/news/health/how-hca-turned-trauma-into-a-money-maker/2169280\" target=\"_blank\" rel=\"noopener\">Tampa Bay Times\u003c/a> reported last year that the hospital chain charged significantly higher “activation fees” than other hospitals.\u003c/p>\n\u003cp>Opponents also countered that adding trauma centers would affect University Medical Center’s ability to provide quality care and train doctors. Some experts say it could diminish the number of patients seen at each center.\u003c/p>\n\u003cp>That’s because the more trauma patients a center deals with annually, the better the results, studies show.\u003c/p>\n\u003cp>“If you can bring all the patients to one place, then those surgeons become really good at dealing with trauma, instead of spreading it out [around a number of facilities],” said Bill Bullard, senior vice president with the Abaris Group, a California-based consulting firm that advises hospitals on emergency care.\u003c/p>\n\u003cp>Ian Weston, executive director of the American Trauma Society, said the trauma system worked well in Las Vegas, which is a credit to ambulances and other first responders and their ability to triage patients to hospitals across the city.\u003c/p>\n\u003cp>Seriously ill patients have the best outcomes when treated at a Level I trauma center, said David Callaway, a professor of emergency medicine at the Carolinas Medical Center in Charlotte, N.C. But “when you have 500-plus casualties and 58 dead … if all the patients went to a Level I, mortality would not be improved, because they would be completely overwhelmed,” Callaway added.\u003c/p>\n\u003cp>Bullard agreed.\u003c/p>\n\u003cp>“In theory, the more centers you have the more people you have to deal with injuries. However, no trauma system is able to handle a tragedy of this magnitude.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>\u003ca href=\"http://www.kaiserhealthnews.org/\">Kaiser Health News\u003c/a> (KHN) is a national health policy news service. It is an editorially independent program of the \u003ca href=\"http://www.kff.org/\">Henry J. Kaiser Family Foundation\u003c/a>.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/361338/las-vegas-faced-a-massacre-did-it-have-enough-trauma-centers","authors":["byline_stateofhealth_361338"],"categories":["stateofhealth_11","stateofhealth_2746"],"tags":["stateofhealth_3116","stateofhealth_2808","stateofhealth_392","stateofhealth_3174","stateofhealth_2519","stateofhealth_3173"],"affiliates":["stateofhealth_3007"],"featImg":"stateofhealth_361344","label":"stateofhealth_3007"}},"programsReducer":{"possible":{"id":"possible","title":"Possible","info":"Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? 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You ask the questions. You decide what Bay Curious investigates. 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Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />","airtime":"SUN 9pm-10pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Code-Switch-Life-Kit-Podcast-Tile-360x360-1.jpg","meta":{"site":"radio","source":"npr"},"link":"/radio/program/code-switch-life-kit","subscribe":{"apple":"https://podcasts.apple.com/podcast/1112190608?mt=2&at=11l79Y&ct=nprdirectory","google":"https://podcasts.google.com/feed/aHR0cHM6Ly93d3cubnByLm9yZy9yc3MvcG9kY2FzdC5waHA_aWQ9NTEwMzEy","spotify":"https://open.spotify.com/show/3bExJ9JQpkwNhoHvaIIuyV","rss":"https://feeds.npr.org/510312/podcast.xml"}},"commonwealth-club":{"id":"commonwealth-club","title":"Commonwealth Club of California Podcast","info":"The Commonwealth Club of California is the nation's oldest and largest public affairs forum. As a non-partisan forum, The Club brings to the public airwaves diverse viewpoints on important topics. The Club's weekly radio broadcast - the oldest in the U.S., dating back to 1924 - is carried across the nation on public radio stations and is now podcasting. Our website archive features audio of our recent programs, as well as selected speeches from our long and distinguished history. This podcast feed is usually updated twice a week and is always un-edited.","airtime":"THU 10pm, FRI 1am","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Commonwealth-Club-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.commonwealthclub.org/podcasts","meta":{"site":"news","source":"Commonwealth Club of California"},"link":"/radio/program/commonwealth-club","subscribe":{"apple":"https://itunes.apple.com/us/podcast/commonwealth-club-of-california-podcast/id976334034?mt=2","google":"https://podcasts.google.com/feed/aHR0cDovL3d3dy5jb21tb253ZWFsdGhjbHViLm9yZy9hdWRpby9wb2RjYXN0L3dlZWtseS54bWw","tuneIn":"https://tunein.com/radio/Commonwealth-Club-of-California-p1060/"}},"considerthis":{"id":"considerthis","title":"Consider This","tagline":"Make sense of the day","info":"Make sense of the day. Every weekday afternoon, Consider This helps you consider the major stories of the day in less than 15 minutes, featuring the reporting and storytelling resources of NPR. Plus, KQED’s Bianca Taylor brings you the local KQED news you need to know.","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Consider-This-Podcast-Tile-703x703-1.jpg","imageAlt":"Consider This from NPR and KQED","officialWebsiteLink":"/podcasts/considerthis","meta":{"site":"news","source":"kqed","order":"7"},"link":"/podcasts/considerthis","subscribe":{"apple":"https://podcasts.apple.com/podcast/id1503226625?mt=2&at=11l79Y&ct=nprdirectory","npr":"https://rpb3r.app.goo.gl/coronavirusdaily","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5ucHIub3JnLzUxMDM1NS9wb2RjYXN0LnhtbA","spotify":"https://open.spotify.com/show/3Z6JdCS2d0eFEpXHKI6WqH"}},"forum":{"id":"forum","title":"Forum","tagline":"The conversation starts here","info":"KQED’s live call-in program discussing local, state, national and international issues, as well as in-depth interviews.","airtime":"MON-FRI 9am-11am, 10pm-11pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Forum-Podcast-Tile-703x703-1.jpg","imageAlt":"KQED Forum with Mina Kim and Alexis Madrigal","officialWebsiteLink":"/forum","meta":{"site":"news","source":"kqed","order":"8"},"link":"/forum","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/kqeds-forum/id73329719","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM5NTU3MzgxNjMz","npr":"https://www.npr.org/podcasts/432307980/forum","stitcher":"https://www.stitcher.com/podcast/kqedfm-kqeds-forum-podcast","rss":"https://feeds.megaphone.fm/KQINC9557381633"}},"freakonomics-radio":{"id":"freakonomics-radio","title":"Freakonomics Radio","info":"Freakonomics Radio is a one-hour award-winning podcast and public-radio project hosted by Stephen Dubner, with co-author Steve Levitt as a regular guest. 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You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Mindshift-Podcast-Tile-703x703-1.jpg","imageAlt":"KQED MindShift: How We Will Learn","officialWebsiteLink":"/mindshift/","meta":{"site":"news","source":"kqed","order":"2"},"link":"/podcasts/mindshift","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/mindshift-podcast/id1078765985","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5","npr":"https://www.npr.org/podcasts/464615685/mind-shift-podcast","stitcher":"https://www.stitcher.com/podcast/kqed/stories-teachers-share","spotify":"https://open.spotify.com/show/0MxSpNYZKNprFLCl7eEtyx"}},"morning-edition":{"id":"morning-edition","title":"Morning Edition","info":"\u003cem>Morning Edition\u003c/em> takes listeners around the country and the world with multi-faceted stories and commentaries every weekday. Hosts Steve Inskeep, David Greene and Rachel Martin bring you the latest breaking news and features to prepare you for the day.","airtime":"MON-FRI 3am-9am","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Morning-Edition-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.npr.org/programs/morning-edition/","meta":{"site":"news","source":"npr"},"link":"/radio/program/morning-edition"},"onourwatch":{"id":"onourwatch","title":"On Our Watch","tagline":"Police secrets, unsealed","info":"For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. 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