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WE had the unfortunate experience of our 14 year-old son neing struck by a car while on his bicycle. We got a phone call telling us to meet him at the only Level 1 trauma center in our region, which happens to be on the other side of the county we live in.

We were sure that the reason they were bringing him there instead of a nearer hospital was because his injuries were grave.

When we arrived at the hospital, we saw our name scrawled on a piece of paper at the reception desk. A social worker wa standing by to accompany us to a private waiting room where we would be kept isolated and minded. This scared the daylights out of us. When they finally had a doctor come and give us some information, it was that Kyle had fractured his jaw and his collarbone and had been badly burned on his arm and leg by the exhaust from the car as it rested atop him. (some wonderful passersby lifted the car off of him and pulled him out. We never did find out who they were.) Serious injuries, but nothing that would require a trip to the trauma center and certainly not the scare they gave us thinking the worst.

At the end of the day, I think a lot of people are needlessly taken to trauma centers. If you've seen the shows on TV, there are always a couple who didn't need to be there to start with. Maybe that's why these places are being over-run.

Yup, you're probably right..a lot of people end up at trauma centers, then their injuries are determined to be not worth it.

Why? Well, its simple...Paramedics and EMTs do not have x-ray machines. They do not have CAT scans or MRI's either. They do have the knowledge that, based on how an injury occured, a person may have a good chance of having a critical injury that just isn't obvious.

Would you take the chance?

re: Serious injuries, but nothing that would require a trip to the trauma center and certainly not the scare they gave us thinking the worst.)))

You're wrong. Vital blood vessels could have been injured by broken bones or internal injuries, and they don't know that until investigated. Then, it's *mighty* nice to have that vascular surgeon waiting uptstairs to keep him from bleeding to death. That's what the higher levels are all about--those surgeons waiting...it's great they were not necessary. What if they had been.

"WE had the unfortunate experience of our 14 year-old son neing struck by a car while on his bicycle. We got a phone call telling us to meet him at the only Level 1 trauma center in our region, which happens to be on the other side of the county we live in. We were sure that the reason they were bringing him there instead of a nearer hospital was because his injuries were grave.

When we arrived at the hospital, we saw our name scrawled on a piece of paper at the reception desk. A social worker wa standing by to accompany us to a private waiting room where we would be kept isolated and minded. This scared the daylights out of us. When they finally had a doctor come and give us some information, it was that Kyle had fractured his jaw and his collarbone and had been badly burned on his arm and leg by the exhaust from the car as it rested atop him. (some wonderful passersby lifted the car off of him and pulled him out. We never did find out who they were.) Serious injuries, but nothing that would require a trip to the trauma center and certainly not the scare they gave us thinking the worst. At the end of the day, I think a lot of people are needlessly taken to trauma centers. If you've seen the shows on TV, there are always a couple who didn't need to be there to start with. Maybe that's why these places are being over-run. ",

The "mechanism" of injury and the burn probably are why he went to a Trauma Center. As an ER doc I would have advised trauma transport.

If I car rested on top of him and burned about 20% of his body... he may have been sicker than he appeared to you. He may have an underlying splenic or hepatic injury and because of his age and good health could have compensated for a period of time. After CT and exam if he was bleeding he would have needed surgery... best to be at a place that has them on site then letting time slip by as your 14 year old bleeds to death in the ER. All bleeding eventually stops but the end point is the question..... (gallows humor).

As for the COBRA violation..... if you don't accept the patient and have protocol set up for transport then you can't be sued, if the other facility offers the level of care you can't provide. That happened about 15-17 years ago when a lawyer was shot in the head in Orlando and all the hospitals were on "diversion" due to overcrowding and the barrister was flown to Daytona I believe.... I was a resident at the time..... beautiful... it didn't make a difference but it put a smirk on the residents faces when we learned about it.

"life's a bitch.... ain't it. or what goes around.... comes around"