Hospital Examinations: Emergency care

LAFAYETTE, Ind. (WLIF) - It's a place many of us hope never to visit, but if you find yourself in the emergency room, will you want to know you're getting the best care. NewsChannel 18 looked at the emergency departments at Lafayette's two new hospitals in "Hospital Examinations."

In an emergency situation there is little time to think. If you or someone you love is involved in a serious accident, can the emergency departments here either at Clarian Arnett or St. Elizabeth East handle the trauma?

The Emergency Departments at Lafayette's two new hospitals handle everything from routine visits to major trauma. Most people will be treated in the emergency department even if they are badly injured. This includes gun shot wounds, falls, and severe cuts.

"We're able to handle a lot of trauma here locally,” said CEO of Clarian Arnett Health Al Gatmaitan.

"We take care of all major trauma here,” said Chief of Emergency Medicine of St. Elizabeth Regional Health Dr. Marc Estes.

There is always the chance you'll be severely injured. Lafayette has three emergency departments. One each at Clarian Arnett, St. Elizabeth Central and St. Elizabeth East, but none of them have a Level One Trauma Center, which deals with the worst kinds of injuries. You'll have to go Indy to find that type of care.

The quickest way there? Air ambulance. Only a small number of patients need to be airlifted to a trauma center, which you can find at Methodist Hospital, Riley Hospital for Children or Wishard Hospital's burn unit. Methodist and Riley Hospitals are in Clarian's health care network.

Statistics provided by Clarian Arnett show only one percent of people who come into the emergency department are flown to a trauma center. The numbers are even lower at St. Elizabeth East and Central. The hospital system said less than half of one percent of those who go to the emergency department are transferred by air to a trauma center. How is that decision made? For Clarian Arnett it depends on if the patient has several different body systems injured.

"So multiple organ or multiple systems failure: fractures, plus two to three other organs are involved,” said Gatmaitan.

For St. Elizabeth Regional Health, the decision is made based on a different set of criteria. Patients go to a trauma center not because of the injuries but because of recovery options.

"Because they have more extensive rehab facilities, physical therapy, occupational therapy,” said Dr. Estes.

There is one significant difference between the two health care system, and it's one that can save time, a precious resource in an emergency. Clarian Health has a digital medical record system. When a patient is flown to a trauma center affiliated with the health system, doctors have immediate access to test results done at Clarian Arnett Hospital. That's not the case for St. Elizabeth Regional Health. There is no instant transfer of records.

"They end up in their trauma room with their trauma team and they do the same thing all over again,” explained Dr. Estes.

Many times the decision to use an air ambulance is made at the scene of an accident, but even that is a rare occurrence. According to the Tippecanoe County Sheriff's Department, an air ambulance was called to the county 15 times in 2009, but only took people to a trauma center four times. This year, a helicopter has come to an accident 13 times and gone to a trauma center six times. It's the first responders on the scene who decide if an air ambulance is needed. Some police agencies can make that call on their own, like the Indiana State Police, but often times if a police officer or fire fighter is the first to arrive, he or she will wait until a medic or EMT arrives to decide to call an air ambulance. If you do end up in an air ambulance, be prepared to pay. Both health systems have their own helicopters. Clarian uses LifeLine. St. Elizabeth's has Stat Flight, formerly PHI. A call center will send the closest available helicopter. Neither service would quote News Channel 18 an estimated cost for a flight, only saying it depends on a variety of factors including insurance reimbursement, type of aircraft used and level of care given.

"If a patient is going to a higher level care, a lot of insurances will cover it,” said LifeLine Paramedic and Medical Base Manager Zach Hale.

Expect to be charged thousands of dollars. An Indiana Health Coverage Program or Medicaid memo from 2009 states reimbursement for an air ambulance flight is covered at $3172.27.

Both air ambulances said programs exist to help those who aren't insured or can't afford the price.