[Congressional Record (Bound Edition), Volume 152 (2006), Part 13]
[House]
[Pages 18538-18539]
[From the U.S. Government Publishing Office, www.gpo.gov]




                         H.R. 5555, TRAUMA BILL

  The SPEAKER pro tempore. Under a previous order of the House, the 
gentleman from Texas (Mr. Burgess) is recognized for 5 minutes.
  Mr. BURGESS. Mr. Speaker, tonight I would like to take a little time 
and speak about the state of our trauma system here in the United 
States.
  I recently introduced a bill, H.R. 5555, the Trauma Care Systems 
Planning and Development Act of 2006. H.R. 5555 would provide grants to 
State trauma systems to improve the coordination of emergency 
departments and bolster the safety net from point of injury, 
transportation, to triage and treatment.
  Mr. Speaker, traumatic injury is the leading cause of death in the 
United States for people under the age of 45. It is the third leading 
cause of death in the general American population, and each day more 
than 170,000 men, women, and children are injured severely enough to 
seek medical care. About 400 of these people will die and another 200 
will sustain long-term disability as a result of their injuries. The 
total cost of traumatic injury in the United States is largely due to 
motor vehicle trauma, an estimated cost of $260 billion.
  Experts estimate that many injury-related deaths could be prevented 
if a minimum standard of trauma care were available to all Americans. 
Many areas in the United States do not have appropriate emergency 
medical services. Several areas report large gaps in transportation 
coverage and lack of access to emergency nurses and doctors.
  To illustrate this point, I have a map that shows the areas of the 
country where residents can reach a trauma center within 60 minutes by 
flying or driving. This map was created by the Trauma Resource 
Allocation Model for Ambulances and Hospitals, which is a computer 
model designed to aid State and regional planners in their decisions to 
locate or relocate designated trauma centers and helicopter pads. It is 
designed to help maximize access to lifesaving trauma care for our 
constituents.
  Mr. Speaker, the blue areas are within 1-hour driving distance; the 
pink areas are within 1-hour flying distance. The 1-hour time limit is 
not arbitrary. In emergency medicine, the first hour after injury is 
referred to as the golden hour. Patients treated within this timespan 
are more likely to recover or have less long-term effects of their 
injury. The longer a person waits for treatment, the worse the outcome 
is likely to be.
  Mr. Speaker, I represent an area of north Texas around the Dallas 
Fort Worth Metroplex, and if you drive from Dallas to Los Angeles, you 
travel about half of that distance in Texas.

                              {time}  2015

  Well, that distance in Texas from the Dallas-Ft. Worth area to El 
Paso is a 10-hour trip. And you can easily make that trip and be 
outside the range of trauma service almost the entire time. That is a 
long drive with the potential for an accident throughout.
  In fact, it would be possible to drive from Mexico to Canada and 
always be more than an hour away from a trauma center. Members might 
find that parts of their districts fall outside the 1-hour marker.
  The Institute of Medicine recently put out a report in June of this 
year titled The Future of Emergency Care. They found four things. 
First, many emergency rooms and trauma centers are overcrowded. Demand 
is growing; supply is dwindling. Ambulances are often diverted from 
crowded hospitals to others that may be farther away, delaying 
treatment time and providing less optimal care. Patients end up boarded 
in the emergency room while they wait for a hospital room.
  Secondly, emergency care is highly fragmented. Cities and regions are 
often served by multiple 9/11 call centers. Emergency medical services 
agencies do not coordinate with their emergency rooms and trauma 
centers. And some emergency rooms are overcrowded, while others remain 
nearly empty.
  There is not effective communication between public safety agencies 
and public health departments. They often use different radio 
frequencies and have different emergency plans. Interoperability, which 
was a big issue during Katrina, is still an ongoing concern.
  There is no nationwide standard for training and certification of 
emergency medical personnel, and Federal responsibility for oversight 
is scattered across multiple Federal agencies.
  Thirdly, critical specialists are often unavailable to provide 
emergency trauma care. Three-quarters of hospitals

[[Page 18539]]

report difficulty finding specialists to take emergency and trauma 
calls. Key specialties are in short supply. Specialists often treat 
emergency room patients without compensation. And there is extremely 
high medical liability.
  Fourthly, the emergency system is ill-prepared to handle a major 
disaster. There is little surge capacity. The emergency medical 
services received only 4 percent of Department of Homeland Security 
first responder funding in 2002 and 2003. Emergency medical technicians 
in nonfire-based services have less than 1 hour of training in disaster 
response, and hospital and EMS personnel lack protective equipment to 
effectively respond to chemical, biological or nuclear threats.
  In response to these four deficiencies, the Institute of Medicine 
made the following recommendations. One, create a coordinated, 
regionalized and accountable system. Two, create a lead agency. Three, 
end emergency department boarding and diversion. Fourthly, increase 
funding for emergency care. Fifthly, enhance emergency care research. 
And finally, promote the EMS workforce standards.
  I have sought with the bill, H.R. 5555, the Trauma Care Systems 
Planning and Development Act, to address this issue. A coordinated and 
thoughtful plan must be applied to improve our trauma care system in 
this country.
  Anyone or their family member could need trauma care in the blink of 
an eye. Wouldn't we all want to know that we are receiving the very 
best trauma care available quickly and efficiently

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