Published on November 07, 2019

Concord Hospital Trauma Program — Standing by to Help in an Emergency

At any time, day or night, when the door to Concord Hospital’s Emergency Department opens for a trauma patient, a specially trained team of medical providers springs into action on what often is the worst day of the patient’s life.

“Trauma patients are inherently complicated because they are not someone who comes in to have a planned procedure,” said Concord Hospital Trauma Program Manager Katie Hartford. “They are patients with multiple injuries, often with social needs and psychological needs in addition to their physical injury.”

For the highest trauma team activation, the team includes an Emergency Department physician, trauma surgeon, trauma advance practitioner, three trauma-trained nurses, laboratory and X-ray technicians, a pharmacist and security. Several medical students, residents or EMT students typically are present. If the patient is a child, a separate pediatric team joins the activation. Everyone works together to rapidly assess a patient’s injuries and treatment options.

“The team accomplishes a lot of tasks in 15 minutes, including completing a full trauma assessment as well as X-rays, lab tests, and getting the patient connected to monitors,” Hartford said.

In April, a survey team from the Committee on Trauma of the American College of Surgeons (ACS) visited Concord Hospital to review the Trauma Program as part of the Hospital’s goal of being verified as a Level II Trauma Center. The ACS concluded that the treatment, facilities, preparedness, trauma prevention education, staff training, documentation and around-the-clock trauma staffing met the Level II requirements.

“We are ready for emergency surgery any time of the day or night,” said Hartford. “We have 24/7 MRI and anesthesia capabilities and resources in-house at all times to take care of critically injured patients. That means patients are able to stay in this Hospital and not be transferred elsewhere for treatment.”

Concord Hospital’s Trauma Program treats approximately 3,000 patients a year, although not all require a trauma team activation. Approximately 2,000 patients are treated in the Emergency Department and return home. The other 1,000 are admitted to the Hospital.

In addition to seeing patients from the 28 communities in the Hospital’s primary service area, Concord Hospital cares for many trauma patients transferred from other hospitals throughout central and northern New Hampshire.

The largest number of traumatic injuries treated at Concord Hospital are from trips and falls. Falls from standing account for 50 percent of injuries. Falls from height, such as ladders or a roof, or falling down stairs, account for another 15-20 percent.

The Trauma Program also has developed a geriatric trauma policy to address the special needs of elderly patients. The average trauma patient at Concord Hospital is 65 or older.

Other elements that enhance Concord Hospital’s Trauma Program are its team members, including Hartford, who work behind the scenes on process improvements. They ensure that trauma patients receive the highest standard of care and track patients, their injuries and types of care to identify areas for prevention and improvement.

Emergency Department providers are on duty 24 hours a day at many hospitals, but Concord Hospital’s Trauma Program also includes neurosurgeons, interventional radiologists, orthopaedic traumatologists, trauma and acute care surgeons and advanced practitioners on duty or available around the clock.

“We have the benefit of the feel of a community hospital with all of the resources of a Level II Trauma Center — the resources you need when you are severely injured,” Hartford said.

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