For patients who have suffered severe injuries, quite honestly, every second counts. —Dr. Troy Madsen
SALT LAKE CITY — In an emergency situation, minutes and even seconds can count, and even a small amount of time can mean the difference between life and death.
From the time a traumatic incident occurs — such as the two bombs that erupted at the finish line of the Boston Marathon on Monday — doctors typically have about an hour to deliver treatment that would save lives and limbs, but also prevent long-term health impacts to a patient.
"It's kind of called the 'golden hour,' where we really want to do things to stop the bleeding or treat whatever severe injury they have before it gets too far," said University Hospital emergency physician Dr. Troy Madsen. "If we can get those patients out of the ambulance and into the emergency department more quickly, we can do those advanced procedures and get the specialists involved when we need to."
Now a new traffic control system will speed ambulances from the freeway to University Hospital and Primary Children's Medical Center, both local level one trauma centers located on the east side of Salt Lake Valley.
The Opticom system, paid for through a partnership between the hospitals, Salt Lake City and the Utah Department of Transportation, sits atop at least 35 intersections throughout the city and allows ambulance drivers to change lights and clear intersections. It's been available in other areas of the valley since the 1990s.
"Having this system in place helps us respond not only to things we see on a day-to-day basis, such as car accidents, chest pain and strokes, but it also better prepares us for a disaster situation to get people out of the scene more quickly and to the emergency department and getting the advanced care they need," Madsen said, drawing a parallel between the Boston bombings and the 2007 shootings at Trolley Square.
"For patients who have suffered severe injuries, quite honestly, every second counts," he said.
Madsen said ambulance personnel often call ahead to brief the emergency department on their incoming patient and provide an estimated arrival time. Physicians can end up waiting for that patient while others go unattended. The traffic system will help give the hospital a better idea of how to prioritize within the department, he said.
Gold Cross Ambulance spokesman Chris DeLaMare said his fleet of about 55 ambulances responds to approximately 100 calls each day, with the majority of those happening within Salt Lake City. Calls can be "anything from a stubbed toe to cardiac arrest to trauma," he said.
"Anything we can do to prevent an accident, we are better off for it," DeLaMare said.
Transmitters attached to the front of an emergency response vehicle, such as an ambulance or fire truck, can send a high-frequency pulse of light to a device that is strategically perched on the traffic light of an upcoming intersection, signaling the light to turn green for the vehicle passing through. Each system costs about $5,000, not counting installation, said UDOT traffic signal engineer Peter Jager.
"By stopping the cross traffic at the intersection, it allows the ambulance to proceed safely, getting a green path all the way through," he said, adding that the strobe effect that ultimately changes the traffic signal cannot be mimicked by other vehicles and is traceable by unique serial numbers housed within each transmitter. The infrared signal also cannot be seen.
"Cars are being built more soundproof all the time and people just can't hear our lights and sirens very well," he said. "Any time we can mitigate any type of accident, that's what we want to do."
Opticom, which has been implemented in cities around the country, has been shown to reduce intersection crashes with emergency vehicles by up to 70 percent, according to the company's website. It also improves response times by up to 20 percent, but Jager said such facts haven't been tested in the Salt Lake Valley.
"If we had a situation here like they had in Boston, and I hope we never do … this sort of system would get people to the emergency department more quickly and more efficiently," Madsen said.