Why Santa Cruz County Depends on Trauma Centers like Stanford's

When Alfonzo Ruben Lopez Espinoza was  in Watsonville, medics immediately decided to fly the 23-year-old parolee to a San Jose-area trauma center.

Santa Cruz County has about 3,000 trauma cases per year, and of those, about 10 to 11 percent are flown on helicopters to three emergency medical centers in Santa Clara County, according to Emergency Medical Services (EMS) director Dr. Kent Benedict.

“All of these have a tremendous amount of experience in dealing with big time trauma,” he said, referring to Santa Clara Valley Medical Center, Stanford University Trauma Center, and Regional Medical Center of San Jose.

But why are these trauma cases flown out on costly helicopters? And why does Santa Cruz County not have its own trauma center?

Time it takes to go over the hill

The winding Highway 17 is notorious for traffic jams, construction work and general delays. That’s why Santa Cruz paramedics don’t want to risk taking someone with a life-threatening emergency by ambulance to one of the Santa Clara County medical centers, said Dr. Benedict.

Santa Cruz emergency medical staffers rely on a “trauma triage system,” in which “they evaluate patients and develop a trauma score,” said Dr. Benedict.

A score of three is given to injuries at high risk; a two is for major traumas that are not as bad; and one for minor injuries. See the chart in the photos above for a visual of the triage system.

Straying on the side of caution, scores of two and three are airlifted out on helicopters, mostly through CALSTAR. These lifts often racking up bills for the patients of upwards of $10,000, depending on their insurance situation, said Benedict.

There are times when a patient is flown to a trauma center, and be found to be suffering from injuries that can be treated at a local hospital, said Dr. Benedict. For example, Lopez-Espinoza, the car crash victim flown out early Monday, actually was uninjured.

Yet 65 to 75 percent of the time, the injury sustained really was life threatening.

“The medics only have 15 minutes to evaluate the patient,” said Dr. Benedict, pointing out that they have to use their best judgment, and cannot afford to take risks.

Lack of medical personnel

In order to have a medical trauma center that’s running 24/7, a lot of staffers are needed. And there simply is not enough medical staff in Santa Cruz County who are also comfortable performing emergency surgical operations.

“We don’t have the capacity to have a 24-hour, full-staffed trauma center,” said Dr. Benedict.

Instead, Dr. Benedict is in talks with Santa Cruz County about upgrading one or two of Santa Cruz’ existing hospitals to a “super community hospital.” 

“These are community hospitals that have been able to upgrade their care,” said Dr. Benedict. That means it would have more staffers, a larger blood bank, and a radiology department.

Yet Dr. Benedict projects that most major traumas would still need to be flown over the hill.

“Maybe there would be a reduction from 10 to 11 percent, to nine percent,” he said. But before Santa Cruz county hospitals can make the upgrade, they must first get the staffing commitment of the doctors and a financial commitment.