Trauma Care Systems Planning and Development Act of 2006

Mr. Speaker, tonight I would like to take a little time and speak about the state of our trauma system here in the United States.

I recently introduced a bill, H.R. 5555, the Trauma Care Systems Planning and Development Act of 2006. H.R. 5555 would provide grants to State trauma systems to improve the coordination of emergency departments and bolster the safety net from point of injury, transportation, to triage and treatment.

Mr. Speaker, traumatic injury is the leading cause of death in the United States for people under the age of 45. It is the third leading cause of death in the general American population, and each day more than 170,000 men, women, and children are injured severely enough to seek medical care. About 400 of these people will die and another 200 will sustain long-term disability as a result of their injuries. The total cost of traumatic injury in the United States is largely due to motor vehicle trauma, an estimated cost of $260 billion.

Experts estimate that many injury-related deaths could be prevented if a minimum standard of trauma care were available to all Americans. Many areas in the United States do not have appropriate emergency medical services. Several areas report large gaps in transportation coverage and lack of access to emergency nurses and doctors.

To illustrate this point, I have a map that shows the areas of the country where residents can reach a trauma center within 60 minutes by flying or driving. This map was created by the Trauma Resource Allocation Model for Ambulances and Hospitals, which is a computer model designed to aid State and regional planners in their decisions to locate or relocate designated trauma centers and helicopter pads. It is designed to help maximize access to lifesaving trauma care for our constituents.

Mr. Speaker, the blue areas are within 1-hour driving distance; the pink areas are within 1-hour flying distance. The 1-hour time limit is not arbitrary. In emergency medicine, the first hour after injury is referred to as the golden hour. Patients treated within this timespan are more likely to recover or have less long-term effects of their injury. The longer a person waits for treatment, the worse the outcome is likely to be.

Mr. Speaker, I represent an area of north Texas around the Dallas Fort Worth Metroplex, and if you drive from Dallas to Los Angeles, you travel about half of that distance in Texas.

Well, that distance in Texas from the Dallas-Ft. Worth area to El Paso is a 10-hour trip. And you can easily make that trip and be outside the range of trauma service almost the entire time. That is a long drive with the potential for an accident throughout.

In fact, it would be possible to drive from Mexico to Canada and always be more than an hour away from a trauma center. Members might find that parts of their districts fall outside the 1-hour marker.

The Institute of Medicine recently put out a report in June of this year titled The Future of Emergency Care. They found four things. First, many emergency rooms and trauma centers are overcrowded. Demand is growing; supply is dwindling. Ambulances are often diverted from crowded hospitals to others that may be farther away, delaying treatment time and providing less optimal care. Patients end up boarded in the emergency room while they wait for a hospital room.

Secondly, emergency care is highly fragmented. Cities and regions are often served by multiple 9/11 call centers. Emergency medical services agencies do not coordinate with their emergency rooms and trauma centers. And some emergency rooms are overcrowded, while others remain nearly empty.

There is not effective communication between public safety agencies and public health departments. They often use different radio frequencies and have different emergency plans. Interoperability, which was a big issue during Katrina, is still an ongoing concern.

There is no nationwide standard for training and certification of emergency medical personnel, and Federal responsibility for oversight is scattered across multiple Federal agencies.

Thirdly, critical specialists are often unavailable to provide emergency trauma care. Three-quarters of hospitals report difficulty finding specialists to take emergency and trauma calls. Key specialties are in short supply. Specialists often treat emergency room patients without compensation. And there is extremely high medical liability.

Fourthly, the emergency system is ill-prepared to handle a major disaster. There is little surge capacity. The emergency medical services received only 4 percent of Department of Homeland Security first responder funding in 2002 and 2003. Emergency medical technicians in nonfire-based services have less than 1 hour of training in disaster response, and hospital and EMS personnel lack protective equipment to effectively respond to chemical, biological or nuclear threats.

In response to these four deficiencies, the Institute of Medicine made the following recommendations. One, create a coordinated, regionalized and accountable system. Two, create a lead agency. Three, end emergency department boarding and diversion. Fourthly, increase funding for emergency care. Fifthly, enhance emergency care research. And finally, promote the EMS workforce standards.

I have sought with the bill, H.R. 5555, the Trauma Care Systems Planning and Development Act, to address this issue. A coordinated and thoughtful plan must be applied to improve our trauma care system in this country.

Anyone or their family member could need trauma care in the blink of an eye. Wouldn't we all want to know that we are receiving the very best trauma care available quickly and efficiently