Eastman isn't suggesting that every small town in America turn its local 25-bed critical access facility into a trauma center. That's extremely impractical.
But what he is suggesting is that local health and political leaders agree to create systems to parlay patients from those smaller hospitals to regional centers as soon as those patients can be safely transported, sometimes by helicopter, sometimes by ground. But transported, he says.
"What I feel—I and others with the same passion for the care of injured patients—is that you, could throw a dart at a map of the U.S. And wherever it lands, in 10 years, if you were injured there you'd be assured that you'd be expeditiously transported to the level of care you needed. That doesn't mean you'd be in a trauma center in an hour. But there'd be a system that got you there as soon as possible."
Creation of such a system will take recognition from leaders in rural areas "that they can't do it all on their own," Eastman says. "And I know from talking with some of them, these rural areas really want these agreements as much as anybody."
"One of the surgeons said to me recently, 'Brent, you know the definition of rural trauma? It's when you get called at 3 in the morning with a big crash on the interstate and multiple badly injured and you drive to the hospital and your truck is the only one in the parking lot.'"
With systems pre-arranged, that one surgeon can get on the phone and call a regional trauma center, even if it's several hundred miles away. "We can say, 'I've got 10 people, but we can take care of two.' And boom, it happens. The helicopter or ground transport comes where appropriate."
That's Eastman's dream for the future, with support from politicians, the healthcare system, and of course, funding specifically called for in the nation's new health reform bill.
Someday, Eastman says, he may move back to Wyoming and retire. And when that day comes, he hopes, the nation's trauma system will be seamless.