Valley Health Magazine

By Clare Frederick

You might not know it exists, until you find yourself flying through Fresno skies – and that's if you're lucky enough to be conscious. On any given day, a thunderous roar from either the Skylife, military Blackhawk, or CHP helicopter, can be heard as they arrive on the helipad. As they rush the injured victim into the facility, dedicated high-speed elevators have no other task but to take the trauma patient down in a matter of seconds to the trauma center. Once there, a top-notch staff does everything in their power to make sure they come out of it alive.

One of the greatest sources of pride in our area is located on the first floor of the Community Regional Medical Center, in downtown Fresno. The world-class, Table Mountain Rancheria Trauma Center at Community Regional, is the only Level 1 trauma center between Los Angeles and Sacramento, and offers local residents constant, around the clock coverage of injuries sustained in an accident or sudden illness. At 56,000 square feet, it is one of the largest facilities of its kind in the state of California, and is the largest redevelopment project in Fresno County history.

When your life is on the line, and every minute counts, you can now receive both trauma and specialized care from cardiologists and neurosurgeons 24 hours a day, seven days a week, under one roof. You might not think about it often, but if you or a loved one is ever injured, you'll be glad to know the Level 1 trauma center insures the best treatment in the world as fast and as effective as possible.

"Trauma is the leading cause of death for anyone under the age of 44 in this country," said Dr. Jim Davis, Chief of Trauma at Community Regional Medical Center. "It's a huge problem, and for every one who is killed, three are disabled permanently. There is really good data that says for any level of injury, if you go to a trauma center, your chances of surviving it, and having a good outcome, are significantly better than if you go to a non-trauma center community hospital."

Dr. Steven Parks, Chief of Surgery at Community Regional Medical Center, has witnessed the evolution of the Level 1 trauma center in his many years at Fresno. "People have always been taken care of by doctors and surgeons, and surgeons developed systems for taking care of people. In the 1970s, they discovered a lot of people died in hospitals from the normal system, because there was not a good understanding of the mechanism of injury, and how they were injured. Because a lot of people died, in regular hospitals, by good doctors, they started looking at the systems to take care of them, and the concept of trauma centers started in the 1970s."

Trauma has quite a history in Fresno. In the 1970s, no hospital claimed a trauma center designation, and trauma patients were simply sent to the closest emergency room. In the 1980s, Valley Medical Center received designation as having the only local Level 1 trauma center in the Central Valley. They changed their name to University Medical Center in 1996. This past April, after years of planning to consolidate services between the two hospitals, patients and hospital staff moved the trauma center at UMC to Community Regional Medical Center. Before the move, a few trauma patients had to go to University Medical Center to get stabilized, before they could be transported to Community Regional Medical Center for specialized services.

This move is significant because now, patients no longer have to travel a couple miles by ambulance to a different hospital to receive surgery from a cardiac surgeon, or neurosurgeon after being stabilized from traumatic injury. They can receive all of the trauma and specialized services at one location.

Space continues to be one of the major issues of the move. There are more jobs than there is area to do it in, and they continue to build. "You look around, and see there's hardhats everywhere," said Dr. Parks, "I don't think we'll ever be done building. It's amazing. We keep getting busier. The activity keeps you on your toes."

Dr. Parks has historically been involved with the trauma system from the ground up. Before coming to Fresno, he worked at San Francisco General at one of the first trauma centers in the nation. After he arrived in Fresno, some of the first steps he took was to make improvements at Valley Medical Center. He later worked on a committee of people in the healthcare industry from Fresno, Madera, Mariposa, and Kern Counties to put together a trauma system. At the same time, he involved himself with training the first paramedics in 1978. The paramedic program eventually joined the trauma system, which also called for better availability to anesthesia, operating rooms, and ICU beds. A commitment was made toward maintaining a trauma system, to carry us through to the next 100 years. In 1982, Parks worked with the federal government, and got the agreement from other hospitals that VMC would be the trauma center in the area.

Much of today's modern trauma system came from the county hospital model, and many hospitals around the nation got their trauma center designation because they had teaching programs which offered a higher amount of manpower, and more dedicated resources, like those found at VMC.

"Out of the National Trauma Data Bank, our success rate, based on the injured severity is very good," said Dr. Parks, "If you have everything all ready, and you can get to that person in that golden hour, you can save a life and have a much better outcome. You'll have less complications too."

"First and foremost, the trauma program has come a long way. We have saved a lot of lives, we have taken very good care of a lot of people, and when I say 'we' I mean our team," said Dr. Davis, "We've trained some really good people who have gone out and are training other people to be really good surgeons."

It takes a huge effort from everyone on staff to maintain a Level 1 trauma center, and most hospitals don't have the resources to provide this kind of service. The Table Mountain Rancheria Trauma Center at Community Regional can frequently run two operating rooms, and sometimes three. To have the ability to run one room, a second team of doctors, nurses, and staff must be on site. They may not be working or making money, but in the event someone is shot, or gets in a car crash, another operating room is required to be open. They need to be on stand-by and ready for immediate action. From there, if somebody new comes in with another motor vehicle crash, a third team will then be called in.

"You pay for anesthesia, scrub techs, nurses, who are all on call, and have to drop what they're doing, and have to come in," said Dr. Davis, "That's a huge commitment from the hospital to pay the salaries, and from the people who work here. Nothing waits, it just gets done."

What is especially important about the nature of the Level 1 trauma center is the unity the staff feels towards each other. It takes a special breed of person to work at a place, where the very atmosphere by nature, is high-powered. "If you're on call here, it's tense," said Dr. Davis, "The people who work here have to be a little bit of an adrenaline junkie. You wind up with an attitude of can-do. This is job one. This is what we do, we do it really well, and it doesn't matter what we have to do, if we have to knock out a wall, we'll get it done."

A huge amount of gratification is attached to the people who work at this particular facility as well. Dr. Davis has served at various hospitals around the nation, but finds this one to be extremely unique. "The amount of pride that's associated with what used to be University Medical Center, and now this building, goes literally from the CEO, all the way to the janitor."

"We're really good at what we do. If you have a winning team, that develops pride, and tradition. The stakes are more. We have seen some really fabulous team efforts," he said. The value of each patient is apparent, and you can tell they believe each patient is somebody who matters to a lot of different people.

The trauma center at Community Regional been pretty well recognized across the nation too. Dr. Davis is the president of the Western Trauma Association. Dr. Parks has been a chairman of the Advanced Trauma Lifesupport. He has taught in Asia, Europe, Australia, the Middle East. His last trip was to Pakistan.

"We've built a trauma center here where nobody in the nation can do it better," Dr. Parks said. He likes taking care of the badly injured the most. "You don't know what's around the corner, and you have to be ready," said Dr. Parks, "You do it with a team of young doctors, and that's exciting. I'm very proud of them."

Fresno has everything in healthcare that you can get anywhere else in the world. The Level 1 trauma center has a high level of quality and commitment which stems from a rich and developed history that has saved the lives of many, and its impact has touched the lives of generations around the world.