Activation Teams for Trauma, Heart Attack, Stroke and Sepsis

In 2015, Hilo Medical Center added Sepsis Activation to its toolkit of activations to trigger immediate care for this very serious infection in the bloodstream. Since 2011, we instituted activation teams as a “best practice” approach in the way we care for trauma, heart attack, stroke, and now sepsis. This best practice originated out of the Hilo Medical Center’s Trauma Program.

When the Trauma Activation Team is activated, the switchboard operator notifies members of the team overhead throughout the hospital with an announcement and ETA (estimated time of arrival) for the ambulance and paramedics: “Trauma Team Activation. ETA 5 minutes.”

Upon activation, Emergency Department nurses and physicians spring into action to prepare the trauma bays to receive patients. Respiratory therapists, radiology technologists, laboratory technicians, and surgeons assigned to the trauma team for that shift immediately report to the Emergency Department to be ready to care for trauma patients as soon as they arrive by ambulance. Once the patient is brought in to the Emergency Department, the team goes to work – assessing, diagnosing, and trouble-shooting. Meanwhile, other members of the Trauma Team, including nurses and staff in the Operating Room and Intensive Care Unit, continue caring for trauma patients throughout their hospital stay and recovery. If the team determines that patients need specialty trauma care, arrangements are made with the air ambulance and trauma centers on Oahu.

The State Department of Health has designated HMC as a Level III Trauma Center. In addition to organizing our Trauma Activation Team, our Trauma Program developed efficiencies in care and communication among the hospital, Hawaii County paramedics, air ambulance transportation and Queen’s Medical Center – a Level II Trauma Center, the state’s highest level of trauma care. A key component of our trauma program is dedicated to preventing further injuries. We participate in many community events and health fairs to offer prevention information on a wide variety of areas such as: alcohol and drug use prevention; helmet and bike safety; distracted driving prevention; and fall prevention. Between 2011 and 2013, HMC’s Trauma Activation Team has cared for over 700 patients.

Thanks to these “best practices” established by the Trauma Program, Hilo Medical Center’s Heart Attack and Stroke Program can provide timely care for heart attack and stroke patients. With the exception of the surgeons and Operating Room staff, the Heart Attack and Stroke Activation Teams are comprised of the same members as the Trauma Activation Team. The Heart Attack Activation Team is activated for a serious type of heart attack called STEMI — commonly known as “The Big One” or “The Widow Maker.” A STEMI is detected by an ST-elevation in a heart attack patient by an abnormal finding in the electrocardiogram. The teams are activated when the switchboard operator makes the overhead announcement: “Stroke Activation. ETA 5 minutes.” and “STEMI activation. ETA 5 minutes.” If heart attack and stroke patients do not need to be flown out to Oahu or Maui for advanced care, patients are monitored in HMC’s Intensive Care Unit and continue their recovery in the Progressive Care Unit. HMC sees an average of 4 STEMIs and 25 strokes per month.

The Heart Attack and Stroke Program focuses on educating the community about the signs of a heart attack and stroke and the importance of calling 9-1-1 immediately. Time is of the essence — the sooner the 9-1-1 call is made, the sooner Hawaii County paramedics can trigger the Activation Team at the hospital before transporting the patient to the Emergency Room. If the patient is brought in on time, we can provide clot-busting medication that could save the patient’s and help reduce the damaging effects of the heart attack or stroke.

These “best practices” have also been applied to Hilo Medical Center’s Sepsis Program to provide timely care for patients with sepsis, a very serious infection in the bloodstream. Early detection and diagnosis are key in treating sepsis. We have built an early warning system in our electronic medical records system to notify our medical team about a patient’s declining condition that indicates the possibility of sepsis. When the Sepsis Team is activated, we spring into action and take lifesaving measures to fight this life-threatening infection. For more information, read the Center`s for Disease Control`s Sepsis Questions and Answers.

Hilo Medical Center’s activation teams have dramatically improved the way we deliver care. We are working with our community to prevent trauma, heart attack and stroke and detect sepsis as early as possible. In the event you or a loved one need us, we are here to provide the best possible care we can deliver.