A major expansion of "teletrauma" care soon will bring lifesaving treatment to critically injured patients throughout Southern Arizona, no matter how many hundreds of miles they may be from Tucson.
The move is happening with a $285,000 donation from Blue Cross Blue Shield of Arizona to University Medical Center, the site of the region's only Level 1 trauma center.
The funds will link UMC trauma surgeons to emergency rooms at nine rural hospitals in Southern and East-Central Arizona — from Bisbee to Sells to the White Mountains — through electronic video technology. It will be implemented within the next year.
That will allow UMC's Level 1 trauma team to work with often-overburdened rural ERs to bring immediate resuscitation and stabilization care to patients badly hurt in remote areas.
Right now, only one rural ER, at Southeast Arizona Medical Center in Douglas, is video-linked to UMC. Due to the success of that pilot project during the past year — the technology has saved at least five lives — Blue Cross agreed to expand the teletrauma system through the entire southern part of the state.
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First to hook up will be ERs in Bisbee, Nogales and Sierra Vista, within the next six months. Emergency rooms in Benson, Safford, Sells, Willcox and Whiteriver will follow within a year.
Studies have long shown that patients injured in remote areas are twice as likely to die as those hurt in urban areas, where access to a trauma center is faster.
"If you're an ER doctor in Douglas and it's 2 a.m. and it's only you, and you get three or four injured patients from a car crash out there, you need help," said Dr. Rifat Latifi, a UMC trauma surgeon and associate director of the Arizona Telemedicine Program.
"There is no question this is going to save lives," Latifi said. "If we can get help to these patients within the 'golden hour,' the outcomes are significantly better in more lives saved with fewer complications."
In many cases, putting the trauma team virtually into the rural ERs will mean patients can be stabilized and adequately treated right where they are, saving an expensive helicopter flight to UMC. In other cases, that flight will be needed, but the patient already will have undergone vital treatment within minutes of injury.
After analyzing the cases of 21 patients handled by teletrauma at the Douglas emergency room, Latifi concluded that five likely would have died without the UMC-Douglas video linkup.
One of those was Douglas resident Dorothea Watkins, who works as a crisis-intervention counselor across the border in Agua Prieta, Sonora. She recently showed up at the Douglas ER with a high fever and a strange lesion on her right arm.
When Latifi, at UMC, zoomed the camera in on her arm, he knew immediately what he was looking at: the early stages of a flesh-eating strep A infection, a virulent bacterium that can dismember or kill within two days.
But Watkins, still thinking it was nothing serious, was refusing care.
"I had no idea what was happening to me," she said, speaking at a press conference Tuesday to announce the expansion.
"This form of strep A is so hard to diagnose, and I had no idea it could kill you. But I heard the doctor (Latifi) say very forcefully I was going to die or lose my arm if I didn't get on the helicopter and get to UMC. That saved my life."
At UMC's trauma center, Watkins underwent multiple surgeries and slipped into a two-week coma before recovering completely.
It was cases like this that persuaded Blue Cross Blue Shield to get telemedicine in every rural Southern Arizona hospital for trauma patients.
"Everyone in the state, in the country, is talking about what to do about health-care costs," said Richard M. Hannon, senior vice president of Blue Cross Blue Shield of Arizona.
"We serve lots of people in these rural communities, and we are always concerned that the rural hospitals stay open and that the standard of care stays at the expected level. We saw this as adding a level of care these communities really need," Hannon said, pointing out that smaller hospitals struggle with a shortage of specialists, especially in acute-trauma care.
Teletrauma care is part of the Arizona Telemedicine Program, based at the University of Arizona Health Sciences Center. Launched in 1996, the program now links with clinics, prisons and hospitals throughout the state, providing video broadcast medical, psychiatric and trauma care.
● Rural Southern and East-Central Arizona hospitals in the teletrauma system:
l Southeast Arizona Medical Center, Douglas
l Copper Queen Community Hospital, Bisbee
l Carondelet Holy Cross Hospital, Nogales
l Sierra Vista Regional Health Center, Sierra Vista
l Benson Hospital, Benson
l Mount Graham Community Hospital, Safford
l USPHS Indian Hospital, Sells
l USPHS Indian Hospital, Whiteriver
l Northern Cochise Community Hospital, Willcox
