By Cristian Ponce, The Californian | Feb. 8, 2018

Chances for Salinas residents to survive a car crash, shooting, puncture wound or fall have increased since a trauma center opened in their backyard three years ago.

The trauma center at Natividad Medical Center is celebrating its three-year anniversary after being designated a Level II trauma center in 2015.

Julie Ramirez, trauma program manager at Natividad, said since its inception, the trauma center and its staff have saved many lives that could have been lost if they had needed to fly to the Bay Area first, which had the closest trauma center prior to the one at Natividad.

"The fact that we have a neurosurgeon on call and available to respond to the bedside and to the operating room within 30 minutes has changed the outcome of many patients that normally probably wouldn’t have survived these injuries," said Ramirez.

While trauma patients age 14 and under are still transported north to pediatric trauma centers in the Bay Area, there have been instances where medical services weren’t able to fly with children because of weather, said Dr. Alex Di Stante, trauma medical director at Natividad.

In those instances, having the trauma center here was vital, he said.

"The only reason they’re alive today is because we’re here and we were able to stabilize them before sending them north," said Di Stante. "Had they gone to any of the hospitals in this community before a Level II trauma center, they would not have survived."

Being able to recognize what type of resources a trauma patient needs and having a trauma surgeon available within 15 minutes is vital, said Ramirez.

"We always have a backup team available that gets deployed and we have a backup trauma surgeon as well to cover any traumas that come in during that time," said Ramirez.

Blunt trauma and car accident injuries are the most common ones receiving treatment at the trauma center, followed by injuries from falls and penetrating wounds coming in third, said Di Stante.

While some may think that gunshot wounds from gang violence may be the top injury at the trauma center, only about 14 percent of injuries are penetrating injuries (gunshot, stab or other piercing wounds), said Di Stante, and those may not be gang-related.

The trauma center at Natividad not only addresses injuries as they come in but also takes it a step further by implementing support programs to try to prevent violence, such as the CHOICE program.

"It’s a program that helps prevent retaliation for patients who are victims of any type of violence, and that’s including gang violence," said Ramirez. "We have a team of interventionalists that screen patients for inclusion into the program and provide counseling and resources."

Statistically, victims will return to the same environment where their injury first occurred, and 55 percent of the victims will be subject to another injury within five years, with 20 percent dying as a result, according to Natividad.

The CHOICE program reaches out when the patient is in a calm environment and provides resources on how to avoid returning to violent lifestyle, according to Natividad.

Ramirez said the program has been very successful and the reinjury rate for people within the program is in the single percentage range.

The program aims to lead people away from gangs but Ramirez notes they have to make the conscious decision to join that program while not being involved in the gang, which is a part of the inclusion criteria for the program.

Di Stante notes that Natividad is also looking into other preventative programs for its patients.

"We try to tailor the trauma prevention education to what the problems are in the county," said Di Stante.

The trauma facility became a Level II trauma center in January of 2015 after being designated by the Monterey County Emergency Medical Services Agency.

The designation came after a two-and-a-half-year effort by Natividad that was a part of a four-year Monterey County EMS process to designate a local hospital as a trauma center, according to Natividad.

A trauma center is comprised of specialized surgeons, staff and equipment to treat the most severe and critical injuries. Trauma centers lower the risk of death in those cases by 25 percent.

In 2017, the trauma center at Natividad began collaborating with EMS to improve the rapid transport of patients, continued community outreach programs, and established specialized training for nurses, among other achievements, according to a press release from Natividad.

Di Stante said they see between 1,400 to 1,500 trauma patients a year and that it is the only facility of its kind between Santa Clara County and Santa Barbara County.

Most Level II centers are only staffed by general surgeons, but Di Stante said the Natividad trauma center is staffed with trauma surgeons who have more training than traditional Level II centers.

Di Stante explained that the staff is trained in courses like the Advanced Trauma Life Support Course, which is a course that is through the American College of Surgeons, as well as other monthly training.

Trauma is the leading cause of death in people up until the age of 45, which also accounts for 41 million emergency visits each year, according to Natividad.

As the trauma center continues to serve patients, Di Stante hopes the public learns about the importance of having a trauma center nearby.

"People think that it’s all about the shootings and the gangs and that it doesn’t affect them," said Di Stante. "The reality is that it affects everybody."

This article was amended to correct the annual trauma number at NMC.

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