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Critical to care: Course offers training to rural physicians, staff

GRAFTON, N.D.—Imagine a 27-year-old victim of a car crash who is confused and complaining of chest, hip and ankle pain.

This is one fictional scenario Sara Suda, director of nurses at Unity Medical Center in Grafton, and her staff recently considered during a new course offered through Altru Health System.

The day-long training, designed by the American College of Surgeons Committee on Trauma, aims to better prepare rural emergency care physicians and staff during the initial care and resuscitation of injured patients. "We've never had something like this before, and it was such a great team building event for all my staff," Suda said. "We learned a lot, and I would love for others to experience the same thing."

William McKinnon, Altru's medical director of regional operations and ER medicine physician, said the hospital system wants to use the course to reduce trauma deaths in rural areas.

Twenty-five percent of its service area is rural, and of that, more than 60 percent of trauma deaths occur in a rural setting, according to Altru.

"The reason that takes place is the delay in services, or the delay in getting patients packaged up and transferred to facilities that have the ability to take care of them," he said.

Altru hopes to offer the same course to other rural hospitals in the future, he said.

Useful training

McKinnon said the course is "all about the approach to patients."

Several Altru medical staff led the training earlier this month. The day was split into lectures and hands-on activities involving a special mannequin to test procedures on.

McKinnon said the lectures covered what's known as the "ABCDE" of trauma—airway, breathing, circulation, disability, exposure and environment. Staff also addressed the process for evaluating several scenarios and improving care, such has having a program in place to review cases regularly to see if improvements can be made, he said.

Suda, who attended the training with at least 20 others, said her staff was able to pose questions and get feedback on their current practices, which she felt was the most useful part of the training.

But the experience was likely beneficial for Altru and Unity Medical staff, she said.

"I think they learned some from the experiences we go through as a small critical access hospital," she said. "We pull together whatever team we can get (during an emergency), whereas Altru has a person for every role."

There are 15 critical access community hospitals within the Grand Forks region, the majority of which are designated as trauma centers from the state of North Dakota or Minnesota, said McKinnon.

The training isn't required for these hospitals but highly recommended by accrediting bodies, he said.

Several communities—including Roseau, Minn., McVille, N.D., and Cavalier, N.D.—have already expressed interest in the training, he said.

Jennifer Johnson

Jennifer Johnson is the K-12 education reporter for The Grand Forks Herald.  Contact her if you have any story ideas or tips and visit