Trauma care after Ike

GALVESTON — Before Hurricane Ike reduced the nation’s top-ranked trauma center to an urgent care facility, medical helicopters were a rare sight in Galveston.

Since the storm, the lifesaving machines land daily on the island’s seawall, school practice fields and practically any clear patch of pavement, flying critically ill or injured patients to Houston.

Ike’s Sept. 13 landfall changed life for islanders overnight, producing severe flooding, which damaged much of the upper Texas coast and left the University of Texas Medical Branch with more than $700 million in damage, lost revenue and other expenses.

Part of that damage was to the emergency room at John Sealy Hospital, which before Ike had been among three Level 1 trauma centers in the region. The others are at Ben Taub General Hospital and Memorial Hermann Hospital, just blocks from each other in Houston.

Inclement weather can ground medical helicopters, leaving major trauma patients facing a 50-mile ambulance ride to Houston’s Level 1 trauma centers in the Texas Medical Center. Some less severe cases are taking a 35-mile ride to Memorial Hermann Southeast, which operates a Level 3 trauma center.

Before the storm, 10-12 medical helicopters landed per year on the island, Mike Carr, director of Galveston Emergency Medical Services, said.

“Now we’re seeing one a day, which is a reasonable average,” Carr said.

Helicopters launch when Galveston first responders place them on standby, to reduce the 12-20 minute flight time to the island, Carr said.

The National Trauma Data Bank last week issued a study ranking John Sealy’s emergency room No. 1 in survival among all the nation’s Level 1 trauma centers.

Brian S. Zachariah, the medical branch’s emergency room director, said the ranking was a feather in the cap for Dr. Bill Mileski’s team. Mileski is the hospital’s chief of trauma services.

“It compares trauma centers equal in size and looks at morbidity, or how many people die,” Zachariah said. “We had the lowest death rate across the country.”

Zachariah said the hospital’s operating room could come online later this month.

“What we are right now, we are basically an urgent care facility,” Zachariah said. “We’re a walk-in clinic, a doc-in-the-box.”

Gone are the trauma physicians, intensive care capabilities and ancillary personnel capable of caring for the critically ill or injured.

“What we’re seeing a lot of are cuts or people hurt from cleaning up houses, broken glass, stepping on nails,” Zachariah said. “We’re also seeing respiratory system problems from people breathing dust and minor complaints for cough or cold. We’re very capable of taking care of those kinds of things.”

The hospital is unable to stabilize trauma patients, but that should change soon, he said.

The hospital will open inpatient beds Monday, but those beds will be used for scheduled admissions or for patients seen through clinics, Zachariah said.

Melinda Stephenson, Mainland Medical Center’s chief executive officer, said the Texas City hospital has seen a 40 percent increase in admissions and a 25 percent increase in surgeries since the storm.

“With UTMB closed, we’re seeing more trauma-type patients than before,” Stephenson said. “But someone suffering from a gunshot wound is better served by going to a trauma center. We’re just not set up for true trauma.”

Stephenson said the medical center is receiving more wreck patients, ones that would have normally gone to UTMB.

“We’ve hired 100 employees from UTMB on an as-needed basis to help out with the volume of calls,” Stephenson said.

Insurance company Aetna said its clients are covered for medically necessary helicopter flights, however a Blue Cross Blue Shield spokeswoman couldn’t offer the same blanket statement.

Generally, the medical helicopter ride is covered by Blue Cross Blue Shield if it’s medically necessary, said Margaret Jarvis, but the company urged clients to review their employer’s medical plan.

For those not covered by insurance, the average PHI Air Medical helicopter flight from Galveston ranges from $12,000 to $15,000, said company spokesman Brad Deutser.

“But we have one of the strongest charity care programs and softest collection policies,” Deutser said. “If they have the means to pay, we do expect payment.”

A message left with Memorial Hermann Hospital, which operates Life Flight medical helicopters, wasn’t returned.