Thursday, November 30, 2017

Your chances of surviving an emergency are better because you live in Louisiana

Author: Dr. Rosanne Prats, Executive Director, Emergency Preparedness

When November ended, so too did the hurricane season. In Louisiana, each spring begins with trepidation of hurricanes and the unknown storm(s) that may rip up the state from bottom to top. So, when the season ends in November, it is with the relief of surviving yet another season.

Louisiana has had its share of game-changing storms; each one bringing different challenges with the opportunity of developing a response system that is “sharper and crisper,” and ingrained in the fabric of each community’s individual and everyday response structures.

One good result is that two Louisiana communities were recently recognized as being the best places to reside if you are ever faced with an emergency; New Orleans and Baton Rouge. The Best Life listing was published in November.

The listing focused on cities that have “fast and furious” emergency response systems, writing, “Some cities just are faster than others when it comes to getting to an emergency and taking action.”

The listing was based on a review the 200 largest metropolitan areas from the National Highway Traffic Safety Administration’s Fatality Analysis Reporting System and state-level emergency room data using a Medicare survey of 4,000 hospitals. The review also included how many emergency medical technical (EMTs) were working in each city, per the U.S. Census. 

Louisiana’s resiliency and ability to advance its preparedness as a state is also demonstrated by advances in trauma care and in the coordination of emergency services.

Concurrent to the Best Life publication, an update by the Louisiana Emergency Response Network, or LERN, demonstrated significant strides in the development of the state’s trauma plan. LERN is a crucial backstop of the State’s emergency preparedness efforts by coordinating the care of patients with a serious traumatic injury or time-sensitive illness. The LERN update was made at the State Advisory Board Meeting on Disaster Preparedness and Response.

LERN’s Director, Paige Hargrove, reported, “This year has been full of growth and opportunity for LERN and for the systems of care across our state … only with continued support can we build systems of care for trauma, stroke, STEMI (heart attack) and all disaster response across Louisiana.”

LERN was created by legislation in 2004 but did not receive state funding until 2007. This was after the need for this effort was clearly demonstrated following Hurricane Katrina through strong advocacy by the Louisiana Recovery Authority (LRA).

Before Katrina, there were two designated American College of Surgeons (ACS) Level 1 trauma centers in the state; Charity Hospital in New Orleans and LSU Medical Center in Shreveport. Today, LERN has increased the network of trauma centers to six ACS-designated Trauma Centers. The result is more than 60 percent of Louisiana residents now have ready access (within a 60-minute drive) to a Trauma Center or Trauma Program.

We are also safer because of better access to heart care. LERN has also significantly advanced access to Stroke and STEMI (heart attack) care by working with pre-hospital and hospital industries to identify pre-determined capabilities using Level 1 – Level 4 designations for stroke and “referral” and “receiving” status for STEMI.  This heart care network now has 107 participating facilities. Louisiana is one of only 12 states and the District of Columbia who have enacted policies around the recognition of stroke facility designations. 

Using Hospital Preparedness Program (HPP) grant funds, the state organized a medical disaster network composed of associations, organizations, hospitals, EMS and public health coordinators.

Coordination and communication has been improved through grants that let us develop and implement a web-based platform, or portal, for reporting during a crisis. For a multiple casualty event, the portal allows responding EMS units to connect with LERN, and then match patients to the most appropriate hospital resources. Hospitals update the portal on a frequent basis so that the centralized dashboard reflects updated capabilities and availability for patients.

In 2016, approximately 808 patients were routed via LERN through the portal. By bridging the gap between a pre-hospital EMS response and then matching the patient to the most appropriate receiving hospital, coordination is assured, and time and lives are saved.

The combination of better care, more access to trauma care and better coordination and communications have led to Louisiana being sharper and crisper in our response to, and readiness for, disasters.

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