Jaime Lewis (Host): Guthrie Robert Packer Hospital in Sayre was recently elevated from a level 2 trauma center to a level 1 trauma center, making it the only level 1 trauma center in Guthrie's 12 county area. Let's learn more about what this means and what it's like to work in a facility like this with Dr. Lindsay MacConaghy, Assistant Program Director of Emergency Medicine at Guthrie Robert Packer Hospital.

 This is Medical Minds, conversations with Guthrie experts. I'm Jaime Lewis. Hello, Dr. MacConaughey. It's great to have you on.

Lindsay MacConaghy, MD: Hi, thanks for having me.

Host: So let's start at the beginning. What is the difference between a trauma center and a regular emergency department?

Lindsay MacConaghy, MD: So, in general, most simplistically, a trauma center is designated as such because it can offer certain resources to the community that would be needed for a trauma patient. For example, they have trauma surgeons that are available 24/7, they have other resources as well that you might need if you, say, get in a car accident, like an orthopedic surgeon or a spine surgeon or a neurosurgeon and we have these easily accessible to us.

It also has to do with the number of trauma patients we might see in a year. Guthrie Robert Packer Hospital has actually been taking great care of trauma patients in this area for several years, because we've been lucky enough to have all of these resources and have had plenty of business and taking care of the trauma patients in this area, but we recently got elevated to a level 1 designation, mostly because we are now much more involved in publications and research in the trauma arena.

But this does offer a huge improvement in the care that we can provide to the community because now our EMS providers know that we are a level one trauma center. So they have very specific protocols as to what types of trauma patients they can bring to different levels emergency departments. So, for example, say you get in a car accident and you are maybe an hour away from our facility.

An EMS provider may not be able to take a very sick trauma patient to a smaller hospital that's maybe 20 minutes down the road. But they would instead have to take the patient to a level one trauma center because of how sick they are. In the past, when we were just a Level 2 trauma center, sometimes a patient who was an hour away would have to be flown or driven even further to get to a Level 1 trauma center.

Now, those patients can get to a trauma center much more quickly. So, EMS can now bring them to us, which is what really matters. So, trauma patients, just like a stroke patient or a heart attack patient, everybody knows that in order for them to do well, it all depends on how quickly they get to the hospital that can provide them care.

So now we are in a position to provide that care much faster to a lot of our trauma centers. So they're able to come to see us when other times more recently, EMS providers may have had no choice but to send them further away to other level one trauma centers in New York State and in Pennsylvania. So we're really excited about this.

It's, I think, really elevated, the level of care we can provide to our wide, vast communities that we care for over the region. I think that's kind of the biggest excitement here. That's what we're all doing this for us to take care of our patients.

Host: Hmm. Mmhmm. Well, you touched a little bit on this already. What do the different levels mean, level two trauma center versus level one trauma center?

Lindsay MacConaghy, MD: The big difference is really about amount of research and publications that are provided. And this is specific for Pennsylvania. Every state is a little bit different in terms of their different hospital designations. We also have to meet certain criteria of number of trauma patients per year, and the different resources we can provide trauma patients.

So that was the main difference. Like I said, we've been hitting our mark for a level one trauma center for actually many years in terms of number of trauma patients we see per year and the types of resources we can provide. So the biggest difference right now is we've gotten more involved in research and publication in the trauma sector.

Host: What's it like for you personally working at a trauma center? What does your typical day or week look like?

Lindsay MacConaghy, MD: Well, as an ER physician, every day is completely different. That's why we go into this. We like to not know what we're getting into when we walk in the door. Being at a level one trauma center definitely supports this type of work environment in a really good way. I mean, this is what we signed up for.

Sometimes the more crazy things get, the better the shift for us, but it really comes down to we love being the ones that people can rely on that are going to be there and be able to step up to the plate and take care of the sickest patients possible. We've definitely seen an uptick in a number of sick trauma patients since we've been a level one trauma center, which is, like I said, what we signed up for.

That's what we want to do. We want to be able to take care of the sickest of the sick when we're not anticipating it and at the drop of a hat. So it's, it's been great. And I'm involved a lot in education as well. So, being a level one trauma center also allows for great educational experiences for our future doctors, which is what we want.

You know, we want our future doctors to get as much experience as possible so they can go off and take excellent care of patients wherever they go.

Host: What are the most common injuries you're seeing in the trauma center?

Lindsay MacConaghy, MD: We see kind of everything. So I would say in the summertime right now, we are very busy with motorcycle accidents and car accidents are kind of always, on the rise. Also, outdoor sporting things like ATV accidents, some swimming accidents, kids being outside and falling from places.

So, lots of broken bones, lots of broken ribs. The deer seem to be everywhere around here. We are a rural trauma center. So, it's, can be quite surprising how many times deers have gotten in the way of motorcycles or cars and caused quite catastrophes that we need to be ready to deal with.

Host: What, for you, has been the most gratifying experience you've had while working at this trauma center?

Lindsay MacConaghy, MD: I would say it's always about the connection with the patients and their families, hands down. Easy answer. That's why a lot of us do this. We want to be the ones to comfort and take care of patients and their families. For most of them, it will be one of the worst days of their entire lives. We can have the opportunity and the privilege to make a great impact on how well that goes, giving a hug to the mother who's crying hysterically because her child just got in a car accident or fell down a bunch of stairs.

 My last shift this week, I gave hugs to family members that had just gotten some bad news from a patient that was a trauma patient of ours. Those are the moments that matter, that are most gratifying or comforting the patients themselves. You know, doing simple things like getting a warm blanket for a woman who fell off her bike and broke her femur, and she's cold and shivering and they really appreciate that and just telling them they're going to get through this. It's going to be okay. Those are the things that make this job most gratifying for sure.

Host: Yeah. Those are the most important things, too. They really add up. Thank you, Dr. MacConaghy, for your work, your expertise in trauma care, and thanks for joining us.

Lindsay MacConaghy, MD: Of course, I will give, if I can make one more shout out, I will say, we're really, really lucky at Robert Packer Hospital, in the emergency department. We have an excellent relationship with our trauma team, and that really contributes to how well we take care of our patients and also greatly improves job satisfaction and my day to day workings in the department.

It's fantastic to be able to go into the trauma rooms when we know we have a sick patient coming in and getting to work happily side by side with our trauma colleagues. It's been a real pleasure, getting to know all of them. The residents all get along, the attendings all get along, it's kind of a unique thing.

This is not the case at every hospital, but we're really, really lucky to have that relationship. We work well as a team and that really elevates how well we can care for our patients.

Host: Right, that ultimately benefits the patients and their families. Well, thanks again and best of luck with all your work with the new Level 1 Trauma Center.

Lindsay MacConaghy, MD: Thank you so much.

Host: That's it for another episode of Medical Minds, Conversations with Guthrie Experts. I'm Jaime Lewis. Do you want to learn more about the new Level 1 Trauma Center at Guthrie Robert Packer Hospital? Please visit guthrie.org to learn more.