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Trauma Level IV Designation Service
Skyline Hospital currently has a Trauma Level IV Designation by the State of Washington. Our hospital routinely provides emergency medical services through our Emergency ACLS Ambulance Service and a 24-hour Emergency Department. A formal trauma team exists to handle the severely injured trauma patient that meets Washington State guidelines for entering the patient into the Trauma System.
Together these services work to retrieve traumatized pediatric and adult patients from the community and provide stabilization of the patient within the scope and capabilities of the hospital’s resources. Life saving surgical interventions are provided by our on-call surgeons when necessary. After resuscitation and stabilization, the patient is transported to an appropriate higher level trauma facility. A written transfer agreement exists with Emanuel Hospital in Portland, Oregon, for transfer of various types of trauma patients. Emanuel Hospital is approximately 63 miles to the west. Some less injured patients are transported to Mid Columbia Medical Center in The Dalles, Oregon, 25 miles to the east. These transfer occur either by the Skyline ACLS Ambulance crew or Lifeflight. Lifeflight is available depending upon current weather conditions. Lifeflight generally has a 20-minute estimated time of arrival to our facility.
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The emergency department is staffed with trauma trained nurses, physicians and on-call surgeons. The approach to treating the trauma patient is guided by an updated trauma plan with attention to the specialized needs of the pediatric patient.
Our primary goal as a designated Trauma Level IV Trauma facility is to heighten our staff’s awareness of the critical importance of providing rapid, efficient stabilization, and transfer of the trauma patient, and providing care to the trauma patient. Procedures performed include chest tubes, advanced airway management, cutdowns, and diagnostic procedures as indicated.
24-Hour Emergency Room
The Skyline Hospital Emergency Department is responsible for providing nursing care to patients of all ages. The Emergency Department cares for everyone from the neonate to the geriatric population. All patients are admitted for at least a Medical Screening Exam. Patients present with minor medical illnesses as well as major trauma. Minor medical illnesses in the pediatric population include strep throat, croup, rashes and earaches. The adult and geriatric populations tend to present with Cardiac, Orthopedic, Respiratory and Gastrointestinal conditions. Since the hospital is located in the Columbia River Gorge where there are many opportunities for outdoor activities, the vacationing population present with a variety of recreational injuries.
The most common procedures performed in the Emergency Room Department setting include suturing, hydration, splinting of orthopedic injuries, aphthalmic examinations, and foreign body removals.
We average 8 patients per day in the Emergency Department. The Emergency Department is open 24 hours per day, 365 days per year. Convenient Care hours of operation are from 9 am to 9 pm, 7 days a week with the exception of being closed on holidays.
The Emergency Department is staffed 24 hours per day by a Registered Nurse and an Emergency Department Physician or Physician Assistant. The Physician Assistant has a back-up physician available to him/her at all time. Additional staff is available to assist the ED nurse as needed. The additional personnel include Respiratory Therapy, Radiology, Lab, a Certified Nursing Assistant, a scribe, clerical support, surgical team support, anesthesia and RNs.A
Critical Access Hospital designation
Skyline Hospital has a Critical Access Hospital designation from the State of Washington. The Critical Access Hospital program was created by Congress in an effort to relieve the financial burden placed upon small rural hospitals who were greatly effected by the changes in the Medicare program in 1995 and the Balanced Budget Act of 1997. These changes have placed a severe financial burden on small hospitals that rely on Medicare to pay for up to 80% of services provided. Critical Access Hospitals are allowed more flexibility with federal rules and regulations and are also eligible for higher level of reimbursement from the Medicare and Medicaid programs.
To qualify for the critical access designation, a hospital needs to meet several criteria:
- Be located in a rural area;
- Treat no more than 15 patients per day, on average;
- Patients tend to stay relatively short periods of time in the hospital;
- Hospital has a family-practice orientation.
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