Friday, May 27, 2011

trauma systems development

McGrath is a small village in Alaska with 346 people located along the south bank  of the Kuskokwim River.  It serves as one of the checkpoints on the 1,049 mile Iditarod Trail Sled Dog Race.  It is located about 221 miles northwest of Anchorage and 269 miles southwest of Fairbanks. 

The provision of health care services including emergency care is administered through the McGrath Clinic.  It is funded by a federal grant through Health Resources Services Administration (HRSA).  The clinic may be staffed by a nurse, physician assistant, or community health aide.  They are provided varying levels of training to stabilize and deal with trauma patients, including ATLS.  There is no physician on-site, but there are some telemedicine capabilities.  For more information on the Alaska Community Health Aide Program visit

Trauma patients are transferred to Anchorage by air utilizing aero-medical transport services.  The McGrath Airport has two asphalt paved runways, and averages about 30 aircraft operations per day.  Given the size of the airport and runway dimensions, only certain types of aircraft can operate in and out of McGrath Airport.  The flight operation time for an aero-medical aircraft from Anchorage to McGrath and back would be roughly one-hour each way; thereby a trauma activation for transfer would require a minimum of 2 hours of flight time, in addition to activation time in Anchorage, medical service provision on scene or at clinic, and transport time from the clinic to McGrath Airport.  The McGrath Airport is located a short distance from the clinic (easily walkable), but would require a patient to be loaded on board an ambulance for the short trip to the actual air field.

After arriving in Anchorage, the patient would be taken to one of the three major hospitals in Anchorage which would have agreed to accept the patient.  If the patient requires any services outside the capabilities of the Anchorage hospital, they would then be subsequently transferred to Seattle.

The McGrath Clinic is a testament to the citizens of McGrath who work tirelessly to provide emergency care both through the professional health care providers who work there along with the community health aides and the aero-medical transport teams that travel to this small village and provide critical care in such an austere environment.


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