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Helen Dandurand (Host): Welcome back to The Well Within Reach podcast. I'm your host, Helen Dandurand. And today, I'm going to be joined by Cris Langellier, Director of Emergency Services at Riverside, as well as Dana Arseneau, Trauma Program Coordinator at Riverside, to talk about our level II trauma designation.

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Host: We are back with Cris and Dana. Thanks for joining me today, ladies.

Dana Arseneau: Thanks.

Cris Langellier: Thank you. Happy to be here.

Host: Yeah. Great. So, let's get started. I think you've both been on the podcast before. But if you could just start, Cris, by telling us a little bit about yourself and your background, that'd be great.

Cris Langellier: Sure. Yes. I have been on one podcast before, and it was a lot of fun. Hoping this will be the same. I've been a nurse here at Riverside since 2001. But I've been an employee here since, well, 1997, so 28 years.

Host: Congrats.

Cris Langellier: Yeah, it's been a good, good little bit of time. So yeah, most of my time's been in the emergency department. I got my nursing degree at KCC, then I went on to University of St. Francis, and then later St. Xavier for a master's degree. Most of my time in the ER, but also worked in IT for a few years, which I really enjoyed, something totally different. The thing I like the most about being a nurse here and a staff member in general at Riverside is just being able to support people in their growth and learning new things and being able to help people who need it.

Host: That's great. That's awesome. A good little background and a little fun fact, I didn't know that you worked in IT before. That's great. And you said, "Oh, I've been here 28 years, since 1997." And I was like, I was born in 1996 and I'm only 28, but I turn 29 very soon.

Cris Langellier: Happy early birthday.

Host: Thank you. I was like, that's not the right math. Actually, it is. So, you've been here my whole life. Dana, could you tell us a little bit about your background?

Dana Arseneau: Yeah. Not as extensive. I'm not as cool as Cris. I have been a nurse here in the ER for 12 years total. So, I started as a new grad, also went through KCC and then went back and got my bachelor's degree. I started as a nurse in the ER, did a little bit of the charge nurse role, and then I've been in the trauma role for about six years now, kind of felt like I've fallen into the place that I've loved, and I'm hoping to stay here and ride it out for the rest of eternity, right?

Host: Eternity. I love it. That's great. Well, we've got two really great guests here today with so much experience, and we're going to talk a little bit about our level II trauma designations. So, let's start with the basics. Can someone tell me what does it mean to be a level II trauma center and how does that differ from other designations?

Cris Langellier: Sure. Being a trauma center provides comprehensive trauma care to the hospital and to the patients. We have resources that are designated just for that. Some of the examples would be we have a specific specialties that are available 24/7, physicians, that kind of thing. And then, we train our staff. We teach them a course called Trauma Nursing Core course right at the hospital, and they get it right at the beginning, and then they do continuing education throughout their entire career.

Host: That is awesome. So, why is it important for Riverside to pursue this designation? And what does it say about our commitment to the community?

Cris Langellier: It's really what is right for the community. The trauma designation, it tells us that our commitment is to providing the best possible care to our patients. We really want to keep these patients in our community as opposed to transferring them somewhere else. And being a trauma center gives us that. It is a difficulty not only for the patient, but also for the family. You know, it's a hardship if you have to go somewhere else for your treatment. So, keeping them here is one of our main goals.

Host: Definitely a goal for our organization to keep people close to home. And so with that, what are some of the requirements that Riverside has to meet in order to achieve this?

Dana Arseneau: Yeah. Most of our requirements that we have to abide by for the state are going to be physician-specific, making sure that we have full call coverages for them. The most important is our surgeons. So, we have to have 24-hour surgeon coverage and 24-hour backup coverage, which basically guarantees that we have a surgeon who can be here within 30 minutes any day or time. So, three o'clock in the morning, they can be here within 30 minutes, even on a Saturday or Sunday.

With that comes our staff for the operating room. They also have to be able to be at the hospital and set up ready to go within 30 minutes day or night. There's protocols that go along with it. And like Cris said, education is a big part that comes to, and community prevention.

Host: There's a lot of peace of mind that comes with knowing that you can have someone here that quickly. I don't know that we touch on this yet, but the differing levels, like what would be in the other levels that we aren't, how do they differ?

Dana Arseneau: Right now, the state of Illinois only has level I or level II. The primary difference is the level Is have a few more subspecialties, and the surgeons have to be able to respond within 10 minutes. So essentially, the surgeons kind of live in the hospital on call like hospitalists.

Host: Got it. Cool. That was helpful. And then, can you not be designated at all though?

Dana Arseneau: You can. Yes.

Host: Okay. Got it. Okay. So, how does being a level II trauma center enhance the collaboration then between emergency services, surgeons and specialists? I know you said, you know, obviously, the timeline of getting them there. But could you elaborate on that a little?

Dana Arseneau: Yeah. We all work together. There are a lot of data points that we have to manage as a team. We meet consistently every month, the whole group of us. The surgeons are very involved and they show up. We had one this morning, a nice meeting, and all of the different specialties show up as well. And the goal is to provide specific great care. So, we are constantly watching those metrics and seeing what we can do to improve as a team.

Host: That's great. The collaboration sounds excellent. I mean, being able to get together when you're not in that emergency situation, in order to talk about things and make things better is really great. So, that's wonderful. We're going to take a quick break to talk about primary care at Riverside.

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And we are back. So, how does this designation impact outcomes for patients in critical times and time-sensitive situations like car accidents, falls, things like that?

Cris Langellier: Nationally, a study revealed a 25% lower risk of death for trauma patients who were treated at a trauma center. Another study revealed that patients who had penetrating trauma, so a knife wound or a gunshot victim, they had a 57% decreased risk of death if they come to a trauma center.

Host: Wow.

Cris Langellier: Yeah. And we have the right tools and the right team to care for these patients quickly and appropriately and to provide the best chance of survival. We also offer inpatient and outpatient rehab services down the line to help them recover.

Host: Wow. So, yeah, it really does sound like the designation makes an impact on the safety of our community. Are there specific technologies or capabilities that we now have, because of the designation we might not have had before?

Cris Langellier: As I said, I've been here for 28 years, so I've seen quite a bit of iteration of the trauma program. And we recently were looking at how long the program's been in place, and I think you said it was two years after it was even invented.

Dana Arseneau: Yes, 1988, and it went live in the state of Illinois in 1986.

Host: That's great.

Cris Langellier: Way longer than you've been born.

Host: Right, right, right. Yeah.

Cris Langellier: So in my time, we've always been a trauma center, like I said. And throughout the years, we've continued to update our equipment just to make sure that we have the most advanced imaging, most advanced operating, which helps us give the best possible care right here in the area. We also offer the strong community prevention programs as Dana mentioned. One of those programs is our Distracted Driving Program. This program, Dana takes a team to local high schools to their driver's ED classes, and she teaches them why it's important to keep your cell phone away. Don't be distracted in any way. With the people in the car, put on your seatbelt. This is an iteration of what used to be the Don't Drink and Drive Program. She talks about that, but it's more important now to make sure that they don't use their cell phones.

Host: Yeah.

Cris Langellier: To toot her horn just a little bit, she's been reviewing the cases for the past few years since she's been doing the program. And she's found that patients that went through the program are not getting in car crashes. So, two years worth of data. So, it's just a start. But all the teens that came into the hospital last year had not been through her program. And this year, out of the teens that have come in involved in trauma, three had been through her program, but they were not drivers. They were in the passenger seat and they were seat belted, so they were listening. So, it proves to me that it's an effective program that we really want to keep going.

Host: How do you kind of run that program? Like do all schools participate? Are there certain ones or how does that work?

Dana Arseneau: It's free and open to any school. So basically, I try and reach out to some of the driver's ed teachers and they can definitely reach out to me too. They can go on the Riverside website, trauma prevention. If you just search Riverside Trauma Prevention, it'll take you directly to the site with my email. And then we just set up a date and time where I come into their class. And then, we take pretty much the entire class period. And we keep 15-year-olds awake and alert and paying attention. And it is just the most mind boggling thing.

Host: That's great. That's great. So, moving on from our different capabilities, the different things that we have going on, in addition to that, we also have, I'm sure, training and education, that plays a role in our emergency team and maintaining trauma readiness. Could you tell us a little bit about that?

Dana Arseneau: Training and education is a major part of my job and probably one of my favorite parts of my job. It's really important to me and to Cris to make sure that our staff is familiar with the trauma processes and specific injuries that can be life-threatening that we don't see very often. We like to drill and we like to educate on those a lot.

Like Cris kind of talked to, we do specific trauma courses. We actually offer up our trauma courses throughout the entire region. So, us and Christ are the only hospitals that do these classes, so we bring nurses in from Silver Cross and St. Joe's and St. Mary's and Morris, they all come to our trauma courses. So, our staff are all completely trained and they're up to date on the highest level of trauma care.

Host: That is fantastic. And I mean, what a gift to have you there to be able to do that training and stuff because not everyone is a good educator and teacher and communicator. And so, to be, specialized in that area, but also be able to, you know, engage people, like that's really great. So, we're glad to have you. And what would you-- both of you could answer this if you'd like-- but what should people in our community know about when and why to choose a level II trauma center for care?

Dana Arseneau: Definitely have an awareness that there's a level II in our area and that we have all of these specialties. So for severe and life-threatening injuries, you need immediate care and those specialties. Specific traumatic mechanisms like car crashes, we're seeing a lot of electric bike and scooter injuries that don't look that bad to begin with, but some of them had been really bad, gunshot wound, stab wounds, major falls, those big injuries, and then any kind of traumatic brain injuries or spinal cord injuries, we're unique that we can offer services with that as well. So, those big kind of life-changing, out-of-the-blue, unfortunate accidents, definitely want to go to a trauma center so that you have the best possibility of surviving.

 There's a rule in trauma called the golden hour, and if you kind of sit back for that first hour, the mortality and morbidity, so the risk of death goes up dramatically if you're not at the right place.

Host: That's a lot of good information. Cris, is there anything you want to add to that?

Cris Langellier: Well, I'll just add based on our trauma program meeting this morning, when Dana had pointed out the bike and scooter crashes, really just wear a helmet because they go so much faster than you realize. And just making that one decision to wear a helmet could be a huge difference in your outcome.

Host: We see that often. Is that more like a summer thing we see a lot of?

Dana Arseneau: I don't want to say they're new, but they've really kind of hyped up quite a bit this year. And yes, definitely comes with the summer. My neighbor's got one and I'm looking all the time, because I'm like, "Oh my gosh. They're so fast." And a lot of younger kids are on them too. So, like Cris said, the helmet is the best way to go.

Host: That's a great thing to note. You know, we do a lot of educating with podcasts and blogs and things about summer safety, things like that. And I don't know that that's one I've seen yet, but that's something we'll have to add to the list. We say bikes and helmets, but we'll add that on there. So, what does our being level II designated mean for the future of emergency and trauma care at Riverside? And where do we go from here?

Cris Langellier: Our goal is to always provide the best possible care for our community. Trauma, no exception. As our community grows, we plan to grow with it and we continue to provide excellent community prevention programs and to help keep our community safe.

Host: Well, I think that's a great place to end then. Thank you guys for being here today. I think we got a lot of information out there.

Dana Arseneau: Thanks for having us.

Cris Langellier: Thank you so much.

Host: Of course. And thank you listeners for tuning into the Well Within Reach podcast brought to you by Riverside Healthcare. For more information, visit riversidehealthcare.org.