Chicago lacks sufficient trauma centers to deal with major terrorist attack

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Among the most uplifting stories to come out of the tragedy is the number of lives saved by the  first responders, volunteers, bystanders and hospital staffs in Boston. As the LA Times reports, the location of six high-level trauma centers less than two miles from the bombing sites saved injured patients, many of whom suffered wounds more commonly identified with the battlefields of war.

Mere words cannot express the sadness and pain suffered in the senseless maiming, wounding and killing of men, women and children on April 15. The uneasiness the attack struck in the hearts of Americans across the nation should raise a troubling question for all of us, especially those of us living in large urban centers. That is, how would hospitals and trauma centers in our cities or towns cope with a tragedy like the one that took place in downtown Boston?

For Chicago, the answer is far from reassuring. Not all of the city's residents can count on having rapid access to the comprehensive emergency care or high level surgical service that Americans value and appreciate most when lives are at risk. Being treated at a Level I Trauma Center increases a seriously injured patient’s chances of survival by an estimated 20 to 25 percent.

Chicago is home to six Level I Trauma Centers serving more than 2.8 million residents. There is, however, only one major trauma center located in the heart of the city’s downtown. No one can predict whether a devastating bombing will ever happen there, but after the terrorists attacks on downtowns in Boston, New York City, and Oklahoma City, the importance of preparation cannot be understated.

Chicago is the most populous city in the Midwest, and one downtown trauma center could not handle the wave of life-threatening injuries that medical staffs responded to at Boston's six trauma centers. Should a devastating emergency occur on or near the remaining five Level I trauma centers in Chicago, other hurdles could jeopardize the rapid delivery of emergency care services. First, traffic in the city would most likely prevent emergency crews from gaining access to the roadways without navigating through dense traffic to get to  other trauma center locations. Secondly, hospitals that are not certified as Level I would not have on staff the surgeons and other physicians trained to treat the most traumatic injuries.

In the wake of 9/11, Chicago and other American cities developed emergency strategies for responding to a terrorist attack or other major threats to their citizens. Officials in Chicago worked with Emergency Management Services to create a regional plan for delivering people to hospitals based on geographical location of incident and type of injury sustained. The city reports it has mapped out a general response effort as well as a response strategy geared towards large events such as the Taste of Chicago, which drew a crowd of 2.35 million visitors in 2011.

Nevertheless, the current situation for young people living on the city's violence plagued South Side illustrates what the absence of Level I trauma care means to residents. Traumatic injuries are estimated to be responsible for more than 161,000 deaths each year. The estimated death rate is 55.9 for every 100,000 persons. Children account for 25 percent of all traumatic injuries. In the case of an emergency event those numbers double.

A recent Huffington Post report states that Chicago has followed the national trend of cities closing trauma hospitals for financial reasons. In recent months, a group of young activists have been pushing for the re-opening of the trauma department closed by the University of Chicago Medical Center 25 years ago. The article quotes a researcher who found no evidence that lives are lost due to the longer travel times for some trauma patients. Statistics are less convincing to the friends and family of a teenager who died in an ambulance on the way to a downtown trauma center.

The call for more Level I trauma centers in Chicago, including downtown, is an argument worthy of being heard in light of our increasingly volatile world. With no way to calculate when or where another disastrous attack or event might occur, access to trauma care centers in Chicago should be seriously examined and evaluated. If the Boston bombing taught anything, it is how critical quick access to well-staffed trauma centers becomes when seconds determine the difference between life or death.

Rush is a member of the House Energy and Commerce Committee. 

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