Leave Fort Worth's city center in any direction and you are heading into horse country. And that means you are heading into traumatic injury territory. Here at Texas Health Harris Methodist Hospital Fort Worth, we regularly see people who have fallen or been ejected from the saddle while barrel racing, bull riding and cow herding.
In Fort Worth, large-animal injuries are No. 4 on the list of causes of major trauma, right after falls from ground level (people trip and break a hip or sustain a head injury), vehicular accidents and falls from heights (construction workers and homeowners on scaffolding and ladders).Texas made a wise decision 20 years ago that gave us all a much better shot at surviving accidents of all kinds. Our state implemented the Texas Trauma System. We set up an infrastructure that supports an integrated, collaborative system that brings fast and effective care from the point of injury through the hospital emergency center and beyond.And the same infrastructure that helps us respond swiftly and effectively to traumatic injuries means that we respond just as well to heart attack, stroke and major disasters.The Texas Trauma System has a unique structure governed by Regional Advisory Councils that have two roles. First, RACs uphold national standards of care throughout their regions; and second, they make decisions about how trauma care resources and funds will be used locally.And it's not just the big trauma centers that have benefited. Small, rural hospitals and EMS systems have been able to train staff and acquire necessary medical and communication equipment using state trauma funds. That ensures that patients who are injured far from a metropolitan area can get effective treatment immediately and be transported swiftly to a higher level of care. Without those funds, rural hospitals and EMS could not afford to invest in trauma care.The Texas Trauma System is recognized nationally, even internationally, for excellence. Every day, I care for trauma patients who will return home and resume their lives. When I started training 30 years ago, many of them would have died. That is a terrific return on our investment.But excellence in trauma care requires ongoing financial commitment. We have to constantly train people and maintain and upgrade expensive diagnostic and communications equipment. And we work every single day to find better ways to treat our patients.Without the training and the tools, people who could have been saved will die, and we will have wasted the investment we have made over the past 20 years.Fortunately, Texas has a dedicated fund to help support trauma care. Unfortunately, some of these funds have been held in reserve by past Legislatures and used to help balance the state budget. The fund currently has a balance of $388 million that hasn't been spent on trauma services, as it should have been, but instead was included in revenue estimates so the state could certify a balanced budget for the 2012-13 cycle.To remedy this problem for the Designated Trauma Facility and EMS Account 5111 and for other dedicated funds, House Speaker Joe Straus has created a committee to examine the problem. I support this effort and hope Texas legislators will, in the coming session, allocate more funds for maintaining the excellence the Texas Trauma System has attained.In a world where traumatic injury, stroke, heart attack and disaster are threats over which we have little control, we need to make sure that the Texas Trauma System is ready to help us when we need it.David Smith, M.D., is medical director of Trauma Services at Texas Health Harris Methodist Hospital Fort Worth.Have more to add? News tip? Tell us
