Not many proposed state constitutional amendments are life or death decisions.
But experts at The Medical Center of Central Georgia and Houston Healthcare believe a “yes” vote on the Nov. 2 ballot will give hundreds of Georgians a fighting chance to live each year.
The amendment proposes a $10 increase in annual car registration fees to provide dedicated funding for a state trauma system described as “fragile, fragmented and dangerously underfunded.”
Currently, Georgia has only 16 trauma centers, many clustered in the Atlanta metropolitan area. Only four – in Atlanta, Augusta, Macon and Savannah – are level one. Vast expanses of the state, particularly south of Macon, have no sophisticated trauma care at all. And the consequences are devastating.
Dr. Dennis Ashley, chief of trauma at MCCG, said trauma victims in Georgia have a 20 percent greater chance of dying than patients in other states.
“That’s 700 people each year,” he said, “because we don’t have an organized system to get patients to the right place at the right time from their scene of injury.”
A trauma victim’s chance of survival diminishes dramatically as distance from a trauma center increases.
“If you’re within 25 miles, the death rate is about 25 percent,” Ashley pointed out. “At 25 to 50 miles, it increases to 42 percent. At 50 to 75 miles, the death rates are astronomical.”
Ashley said the money would be used to increase the number of trauma centers – at least 30 are needed.
“And in the areas of the state that do not have the resources, we need better transportation and communication systems to get patients out of there quickly,” he said. “We do a better job of getting patients off the battlefield in Iraq and Afghanistan than we do in Georgia.”
Houston Healthcare, with hospitals and emergency departments in Warner Robins and Perry, likely would not become a trauma center due to the close proximity of MCCG. But the county-wide complex would benefit from additional equipment, training and a more direct, immediate lash up with the level one complex at MCCG.
“From the time of the accident until you’re to the trauma surgeon, every minute counts,” stressed Sabrina Griffin, director of emergency care at Houston Medical Center in Warner Robins.
“Any intervention can be critical and that’s why EMS, ER and community training is so important,” she said.
David Borghelli, Houston Healthcare’s director of emergency medical service, said the “golden hour” is critical for trauma victims.
“If the trauma surgeon can intervene within one hour, the chance of survival increases significantly,” he said. “But that hour doesn’t begin when we’re notified. It begins when the accident happens. And even with helicopters, it’s difficult to get patients to a trauma center within one hour in some parts of Georgia.”
Ashley believes many Georgians have a false sense of security. They have a med-stop or emergency room near by and believe they are protected should an accident happen.
“But that’s a myth,” he stressed. “If you have a life-threatening trauma injury, you need a trauma team ready to go 24/7. Most ERs don’t have that. There are more than 100 emergency rooms in Georgia and only 16 have trauma teams ready to go.”
Houston County residents are not excluded, he noted, unless they plan to remain in the immediate area 24 hours a day, seven days a week.
“The problem is: How many times do they go to Panama City or Disney World?” he asked. “When they do that, they are very quickly away from the luxury and protection of a trauma center.”
Borghelli likes the amendment because it would set up a dedicated funding source.
“The money would not go into the general fund,” he said. “It would go directly to trauma care and decisions to use the money would be made by users of the trauma system.”
Nor would the money largely go to the Atlanta area, assured Griffin.
“They wouldn’t get all the money,” she said. “It would be evenly distributed.”
Borghelli understands that voters may be reluctant to increase the tag fee in tough economic times.
“I’m strapped just like everyone else,” he conceded. “I’m not a big tax guy and I want to make sure what I pay will be used efficiently. But after being in this industry so long, I know this will be used right.”
The decision is not a political one, the EMS director added.
“When Dr. Death comes, he doesn’t care what political party you are,” he said.
Stacie Walker, nurse manager for the Perry Hospital emergency room and intensive care unit, has a more personal reason for supporting the amendment.
“I have two small children and two vehicles,” she said, “and my children are definitely worth $20 a year to me.”
David Borghelli, Houston Healthcare director of emergency medical service
Stacie Walker (in green hospital garb), nurse manager for Perry Hospital ER and ICU
Sabrina Griffin, Houston Medical Center director of emergency care.