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Featured, from left: Paul M. Vazaldua, Jr., Vice President of Organizational Leadership and Government Affairs for Hidalgo County EMS/South Texas Air Med; Rep. Terry Canales, D-Edinburg; David de Los Santos, EMT-P, Business Development Manager, Hidalgo County EMS/South Texas Air Med; and Shawn Snider, Fire Chief, City of Edinburg. This portrait was taken on Thursday, February 14, 2019, during an event hosted by the Edinburg Mayor and Edinburg City Council at Edinburg City Hall to congratulate Canales for his recent appointment as Chair of the House Committee on Transportation.

Photograph By MARK MONTEMAYOR

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Hidalgo County EMS/South Texas Air Med finalizing a plan to provide helicopter air ambulance service to area hospitals; resource needed for Level I trauma center hopes for Valley

By DAVID A. DÍAZ
Legislativemedia@aol.com

Leaders for Hidalgo County EMS/South Texas Air Med on Monday, February 18, 2019, said they are finalizing a plan to provide helicopter air ambulance service to area hospitals, an announcement that came soon after Air Evac Lifeteam in McAllen immediately ceased operations on Thursday, January 31, 2019.

Air Evac Lifeteam had been operating from McAllen Medical Center since its October 2011 opening, according to an Air Evac Lifeteam press release distributed to media outlets in the Valley.

“We anticipate to launch a helicopter air ambulance service within the next 90 to 120 days,” said Kenny Ponce, President/CEO of Hidalgo County EMS/South Texas Air Med. “It’s something we have been working on the past several months to ensure that this community has this type of service. In the meantime, we do have two fixed wing (aircraft) ambulances for emergency flight service.”

Paul M. Vazaldua, Jr., Vice President of Organizational Leadership and Government Affairs for Hidalgo County EMS/South Texas Air Med, said the region’s residents are fortunate to have the largest EMS (emergency medical service) company south of San Antonio with the vision to make helicopter air ambulance service available.

“Hidalgo County EMS services 90 percent of Hidalgo County residents, from pediatric to geriatric patients – and every person in between. We think of everyone. We always remember, ‘What if it is my baby or my grandma who needs helicopter ambulance service?’” Vazaldua said. “We deeply care for all families. It is this high level of dedication to life-saving public service that inspires Hidalgo County EMS and its sister company, South Texas Air Med, to move forward with this initiative to provide helicopter ambulance service.”

Bringing helicopter air ambulance service back to Hidalgo County also will help Gov. Greg Abbott and Valley state lawmakers in Austin to secure state funds needed to pay for the establishment of Level I Comprehensive Trauma Center(s) in the Valley.

“Without a helicopter air ambulance service, it would be very difficult for our outstanding hospitals to be considered a Level I Comprehensive Trauma Center,” noted Vazaldua. “There are no Level One Comprehensive Trauma Centers in the Valley.”

A Level I Comprehensive Trauma Center is a comprehensive regional resource that is a tertiary care facility central to the trauma system. A Level I Comprehensive Trauma Center is capable of providing total care for every aspect of injury.

Air medical services is a comprehensive term covering the use of air transportation, airplane or helicopter, to move patients to and from healthcare facilities and accident scenes. Personnel provide comprehensive prehospital and emergency and critical care to all types of patients during aeromedical evacuation or rescue operations aboard helicopter and propeller aircraft or jet aircraft. (https://en.wikipedia.org/wiki/Air_medical_services)

“With 430 highly-trained staff members, basic/advanced paramedics, certified flight paramedics, registered nurses, and support personnel, Hidalgo County Emergency Service Foundation brings the unmatched abilities to promote, extend, and save lives in the Rio Grande Valley, a major metropolitan region with an estimated population of 1.4 million residents or more,” Vazaldua said. “We pride ourselves on EMS (emergency medical services) training. Our experienced men and women are ready at a moment’s notice to provide top quality care and support services for our patients and professional associates. Our EMT B/A and Paramedic staff are highly skilled and participate in training and refresher courses on a regular basis.”

Hidalgo County EMS/South Texas Air Med have more than 100 ambulances, wheel chair vans, supervisor units, as well as a communications bus used for disasters, and a special operations trailer equipped for mass casualty incidents, and two fixed wing Beechcraft King Air 90 air ambulances dedicated to emergency transfers.

Hidalgo County EMS features ground transport services through its fleet of MICUs, which stands for Mobile Intensive Care Unit. An MICU is generally defined as a specially designed vehicle with the capacity for providing emergency care and life support to those severely injured or ill at the scene of an accident or natural disaster while transporting them to a medical facility where life-saving treatment may continue.

South Texas Air Med provides its critical care medical services through its pair of sophisticated fixed wing air ambulances.

The day before the Air Evac Lifetime stopped operations in the region, Hidalgo County EMS/South Texas Air Med officials had declared they were already building upon their impressive ground and fixed wing (propellor aircraft) ambulance resources in deep South Texas.

Hidalgo County EMS/South Texas Air Med have launched the availability of ground critical care units and fixed wing propellor aircraft ambulance services, which are unmatched in our medical profession in the Valley,” said Vazaldua. “I am proud to announce that we are the first 911 and patient transfer firm south of San Antonio which has this superior quality of services. We are licensed and recognized by the Texas Department of State Health Services, and our MICU (Mobile Intensive Care Unit) licensed ambulances are equipped with over and above the minimum levels required by the State of Texas.”

With Hidalgo County EMS/South Texas Air Med’s sophisticated ground and air transportation ambulance networks already in place, “we are ready, willing and able to serve the needs of Level I Comprehensive Trauma Centers,” Vazaldua emphasized.

During the ongoing 140-day 86th Texas Legislature, which began on Tuesday, January 8, 2019, Abbott and Valley state lawmakers in Austin are looking for ways to provide funding for the creation of additional Level I Comprehensive Trauma Centers throughout the state – including in deep South Texas.

The Valley state legislative delegation, supported by Abbott, is seeking state funds to upgrade at least one, if not more, of the numerous area hospital trauma centers to Level I Comprehensive Trauma Center.

Tyler, with a 300,000 population, has a Level I and Level II trauma center. Killeen-Temple, with a combined population of 400,000, has a Level I and Level II trauma center. Lubbock, with 300,000 residents, has a Level I and Level II trauma center, and an additional Level II center.

According to the most figures by the U.S. Census Bureau, as of July 2017, the estimated population of the Rio Grande Valley was 1,370,424 (Hidalgo County: 860,661; Cameron County: 423,725; Starr County: 64,454; and Willacy County: 21,584).

Abbott, in a letter addressed earlier this fall to the Rio Grande Valley state legislative delegation, has promised to use his powerful influence in the Texas Legislature and elsewhere to help secure state money to establish at least one Level I Comprehensive Trauma Center for South Texans.

“A Level I trauma center would strengthen the healthcare network in times of disaster, and it would also serve as a needed resource to the 1.5 million people who call the Rio Grande Valley home,” Abbott stated in his letter, dated September 26, 2018. “This is why I fully support efforts to establish this goal.”

The governor’s support was prompted by a letter signed by the area’s state legislative delegation in mid-September 2018, and presented to Abbott by Rep. Terry Canales, D-Edinburg, where South Texas legislators urged Abbott to help secure state money for a Level I Comprehensive Trauma Center(s) in the Rio Grande Valley, and for improved statewide trauma preparedness.

“Having access to a Level I trauma center is a critical component of disaster response and preparedness,” Abbott further stated. “During my travels around the state, I have heard from many Texans about the importance of the trauma system and the need to strengthen it. The reasons differ as to why the network should be strengthened, but there seems to be consensus that enhancements are needed. These issues should be included in discussions as Texas prepares for further disasters.”

(https://edinburgpolitics.com/2018/11/27/abbott-support-trauma-centers-south-texas/)

Hidalgo County EMS/South Texas Air Med are the two primary medical specializations of Hidalgo County Emergency Service Foundation, which was established in 2007, to better serve the ill and injured in South Texas. Today, Hidalgo County EMS/South Texas Air Med deliver advanced emergency medical services throughout the Lone Star State and the rest of North America.

Hidalgo County Emergency Service Foundation has locations throughout deep South Texas, with its main office located at 1415 W. Owassa Road in Edinburg.

In addition to having state-of-the-art ground and air transport emergency ambulances and the extensive support systems needed to protect and save lives, Hidalgo County EMS/South Texas Air Med also employ the highest principles and uncompromising standards deserved by their patients.

Among the many other critical care technology, skills and resources provided to patients by Hidalgo County EMS/South Texas Air Med are:

• Full patient diagnostic monitoring. Hidalgo County EMS/South Texas Air Med carry Physio Control LP15’s: These units come equipped with 12 lead diagnostic monitoring, capnography, SPO2, and fully automatic NIBP. These units allow medical experts to constantly monitor their patients without interruption during patient care and treatment.

• Patient transport vents. Hidalgo County EMS/South Texas Air Med carry LTV Series 1200 patient care ventilators. This ventilator, which can accommodate adult and pediatric patients of any size, provide critical care level for both ground and air transports.

• IV pumps. Hidalgo County EMS/South Texas Air Med use the IVAC Medsystem III IV pumps and MEDX MedFusion IV syringe pumps. Between these two pumps, medical professionals can effectively manage the adult or pediatric critical care patient. EZ-10

• Intraoseous infusion. Hidalgo County Emergency Service is the first EMS provider in the Rio Grande Valley to carry and utilize the EZ-IO. This device insures that critical care professionals have a patient route for fluid resuscitation and medication administration. This device is used for patients involved in major trauma or illness.

• Critical care transport. Hidalgo County EMS utilizes mechanical ventilators, IV pumps, advanced cardiac monitoring, therapeutic hypothermia protocols, arterial line monitoring and more advanced critical care services.

Trauma center levels explained

According to the American Trauma Society (ATS) (https://www.amtrauma.org), physical trauma is severe blunt, blast or penetrating injury primarily caused by automobile crashes, gunshots, knife wounds, falls, battery, or burns.

The survival of trauma patient is reliant upon the strength of the trauma system in that patient’s geographical area. The trauma system must provide:

• Immediate response and medical care at the scene of the injury;
• Rapid transport from the scene of the injury to a qualified trauma medical facility; and
• Qualified trauma medical facilities capable of delivering immediate medical care and ongoing treatment for the injured person(s).

Designation vs. Verification

Trauma center levels across the United States are identified in two fashions – a designation process and a verification process. The different levels (ie. Level I, II, III, IV or V) refer to the kinds of resources available in a trauma center and the number of patients admitted yearly. These are categories that define national standards for trauma care in hospitals. Categorization is unique to both adult and pediatric facilities.

Trauma center designation is a process outlined and developed at a state or local level. The state or local municipality identifies unique criteria in which to categorize trauma centers. These categories may vary from state to state and are typically outlined through legislative or regulatory authority.

Trauma center verification is an evaluation process done by the American College of Surgeons (ACS) to evaluate and improve trauma care. The ACS does not designate trauma centers; instead, it verifies the presence of the resources listed in Resources for Optimal Care of the Injured Patient. These include commitment, readiness, resources, policies, patient care, and performance improvement.

This is a voluntary process by the Trauma Center being verified and lasts for a three-year period.

Trauma Center Levels

As mentioned above, trauma categories vary from state to state. Outlined below are common criteria for trauma centers verified by the ACS and also designated by states and municipalities. Facilities are designated/verified as adult and/or pediatric trauma centers. It is not uncommon for facilities to have different designations for each group (ie. a trauma center may be a Level I adult facility and also a Level II pediatric facility).

Level I

Level I trauma center is a comprehensive regional resource that is a tertiary care facility central to the trauma system. A Level I trauma center is capable of providing total care for every aspect of injury – from prevention through rehabilitation.

Elements of Level I trauma centers include:

• 24-hour in-house coverage by general surgeons, and prompt availability of care in specialties such as orthopedic surgery, neurosurgery, anesthesiology, emergency medicine, radiology, internal medicine, plastic surgery, oral and maxillofacial, pediatric and critical care;
• Referral resource for communities in nearby regions;
• Provides leadership in prevention, public education to surrounding communities;
• Provides continuing education of the trauma team members;
• Incorporates a comprehensive quality assessment program;
• Operates an organized teaching and research effort to help direct new innovations in trauma care;
• Program for substance abuse screening and patient intervention; and
• Meets minimum requirement for annual volume of severely injured patients.

Level II

A Level II trauma center is able to initiate definitive care for all injured patients.

Elements of Level II trauma centers include:

• 24-hour immediate coverage by general surgeons, as well as coverage by the specialties of orthopedic surgery, neurosurgery, anesthesiology, emergency medicine, radiology and critical care;
• Tertiary care needs such as cardiac surgery, hemodialysis and microvascular surgery may be referred to a Level I trauma center;
• Provides trauma prevention and continuing education programs for staff; and
• Incorporates a comprehensive quality assessment program.

Level III

A Level III trauma center has demonstrated an ability to provide prompt assessment, resuscitation, surgery, intensive care and stabilization of injured patients and emergency operations.

Elements of Level III trauma centers include:

• 24-hour immediate coverage by emergency medicine physicians and the prompt availability of general surgeons and anesthesiologists;
• Incorporates a comprehensive quality assessment program;
• Has developed transfer agreements for patients requiring more comprehensive care at a Level I or Level II Trauma Center;
• Provides back-up care for rural and community hospitals;
• Offers continued education of the nursing and allied health personnel or the trauma team; and
• Involved with prevention efforts and must have an active outreach program for its referring communities.

Level IV

A Level IV trauma center has demonstrated an ability to provide advanced trauma life support (ATLS) prior to transfer of patients to a higher level trauma center. It provides evaluation, stabilization, and diagnostic capabilities for injured patients.

Elements of Level IV trauma centers include:

• Basic emergency department facilities to implement ATLS protocols and 24-hour laboratory coverage;
• Available trauma nurse(s) and physicians available upon patient arrival
• May provide surgery and critical-care services if available;
• Has developed transfer agreements for patients requiring more comprehensive care at a Level I or Level II Trauma Center;
• Incorporates a comprehensive quality assessment program; and
• Involved with prevention efforts and must have an active outreach program for its referring communities.

Level V

A Level V trauma center provides initial evaluation, stabilization and diagnostic capabilities and prepares patients for transfer to higher levels of care.

Elements of Level V trauma centers include:

• Basic emergency department facilities to implement ATLS protocols;
• Available trauma nurse(s) and physicians available upon patient arrival;
• After-hours activation protocols if facility is not open 24-hours a day;
• May provide surgery and critical-care services if available; and
• Has developed transfer agreements for patients requiring more comprehensive care at a Level I though III Trauma Centers.

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For more information, please contact Paul M. Vazaldua, Jr., Vice President of Organizational Leadership and Government Affairs, at 956/451-6775. For more on this and other Texas legislative news stories which affect the Rio Grande Valley metropolitan region, please log on to Titans of the Texas Legislature (TitansoftheTexasLegislature.com).

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