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54-574: NLEMMC is a Level II trauma center and a home for one of three helicopters from Lifeflight of Maine . Northern Light Eastern Maine Medical Center is also a major training affiliate of the University of New England College of Osteopathic Medicine . According to Leapfrog Group , NLEMMC is one of 16 hospitals that were "A"-rated for safety in Maine; 80% of the state's hospitals received "A"-grades, surpassed only by Massachusetts with 83%. In March 1891,

108-775: A "casualty department" or "accident and emergency") without the presence of specialized services to care for victims of major trauma . In the United States, a hospital can receive trauma center status by meeting specific criteria established by the American College of Surgeons (ACS) and passing a site review by the Verification Review Committee. Official designation as a trauma center is determined by individual state law provisions. Trauma centers vary in their specific capabilities and are identified by "Level" designation, Level I (Level-1) being

162-540: A $ 40 million equipment upgrading project. The new building will allow the hospital to operate at its licences capacity of 411 beds, as well as being home to expanded and upgraded neonatal care facilities, obstetrics , cardiac healthcare services, and new operating theaters. Northern Light Eastern Maine Medical Center and its parent company, Northern Light Health , collaborated with Aroostook Medical Center , Inland Hospital , Sebasticook Valley Health , and six Wal-Mart stores, to open up The Clinic at Wal-Marts inside

216-555: A Level III trauma center. It provides initial evaluation, stabilization, diagnostic capabilities, and transfer to a higher level of care. It may also provide surgery and critical-care services, as defined in the scope of services for trauma care. A trauma-trained nurse is immediately available, and physicians are available upon the patient's arrival in the Emergency Department. Transfer agreements exist with other trauma centers of higher levels, for use when conditions warrant

270-465: A day at the hospital: Key elements include 24‑hour in‑house coverage by general surgeons and prompt availability of care in varying specialties—such as orthopedic surgery , cardiothoracic surgery , neurosurgery , plastic surgery , anesthesiology , emergency medicine , radiology , internal medicine , otolaryngology , oral and maxillofacial surgery , and critical care , which are needed to adequately respond and care for various forms of trauma that

324-455: A deadly weapon. In the United States, Robert J. Baker and Robert J. Freeark established the first civilian Shock Trauma Unit at Cook County Hospital in Chicago, Illinois on March 16, 1966. The concept of a shock trauma center was also developed at the University of Maryland, Baltimore , in the 1950s and 1960s by thoracic surgeon and shock researcher R Adams Cowley , who founded what became

378-465: A letter from their primary care physician stating the reason for their admission and a statement as to the patient's ability to pay. Charles Hamlin explained that "while certain regulations are necessary and it is not practicable to admit a large number of patients free, the trustees believe that it is better to err on the side of liberality and they have deemed the wisest policy to be a liberal one." A dental surgeon, Dr. Langdon S. Chilcott, began work for

432-429: A medical staff, headed by Drs. Woodcock, McCann, Swett, and Edmunds; and a surgical staff headed by Drs. Simmons, Mason, Hunt, Robinson and Phillips. Later that same year, the board of trustees voted to allow the hospital matron to set the cost of boarding at the hospital and arrange for bill collections. They also voted to disallow nonresidents of Bangor from being admitted to the hospital, except in an emergency, without

486-518: A notice in a local newspaper announcing that a Bangor General Hospital would open its doors on June 7, 1892; this caused some controversy over whether such a notice constituted "advertising" and thus violated the Medical Code of Ethics . A paper was read on the issue at the annual AMA meeting in Milwaukee , and a Dr. D. A. Robinson argued for the hospital. The new hospital opened on schedule in

540-472: A one-day picket near the hospital, the first nurses' strike in NLEMMC's history and creating public concern that the hospital would be understaffed during the strike. The Hospital responded by initiating a three-day lockout of its unionized nursing staff. Further controversy was generated when it was discovered that the hospital's recruiting service was seeking scabs on Craigslist . In previous years, NLEMMC

594-432: A patient may suffer, as well as provide rehabilitation services. Most Level I trauma centers are teaching hospitals/campuses. Additionally, a Level I center has a program of research, is a leader in trauma education and injury prevention, and is a referral resource for communities in nearby regions. A Level II trauma center works in collaboration with a Level I center. It provides comprehensive trauma care and supplements

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648-563: A practitioner or the hospital." The executive director of the Maine Medical Association , Gordon Smith, stated that the bylaw was "really a gag order." The bylaw would have prevented doctors from addressing concerns they had with how the hospital is run. A similar issue had been raised a few years earlier banning criticism of HMO plans, but had been struck down. In 2011, the hospital's Maine State Nurses Association member staff went on strike , complaining of issues with

702-596: A problem again. In 1902, a children's ward was suggested, and in 1903 the hospital began to fundraise for its construction. The project was postponed in 1904 due to a typhoid fever outbreak. The 54-bed hospital housed 75 typhoid patients, who slept in linen closets and offices. Hospital physicians blame the outbreak on the city's drinking water supply, which was piped in from the Penobscot River . Ellen Paine resigned from her position as hospital superintendent in 1906, and opened her own Paine Hospital. This hospital

756-483: A public meeting in Bangor resulting in a petition being circulated calling for the "establishment, operation, and maintenance of a General Hospital for the charitable and benevolent purposes of aiding, treating and relieving the sick, injured and disabled..." The petition was signed by 70 citizens. A year later, five physicians : Doctors William Mason, Walter Hunt, Everett Nealey, William Baxter and William Simmons published

810-458: A rented space in the Mace House . A Boston City Hospital graduate, Elizabeth Spratt, was hired as superintendent of the hospital and organized a school for nurses. That summer, three students enrolled into the program, and those students served as the primary nursing staff under Spratt. December saw the incorporation of the hospital, and Charles Hamlin stepping up as president of what is now

864-487: A sub-speciality prior to becoming a consultant. The typical total length of education, training and post-secondary school is 12–14 years. Otolaryngology is among the more highly compensated surgical specialties in the United States. In 2022, the average annual income was $ 469,000. reconstruction (*Currently recognized by American Board of Medical Subspecialties ) Study of diseases of the outer ear, middle ear and mastoid, and inner ear, and surrounding structures (such as

918-417: A transfer. A Level V trauma center provides initial evaluation, stabilization, diagnostic capabilities, and transfer to a higher level of care. They may provide surgical and critical-care services, as defined in the service's scope of trauma care services. A trauma-trained nurse is immediately available, and physicians are available upon patient arrival in the emergency department. If not open 24 hours daily,

972-432: A traumatic injury and arrange for transfer of the patient to a higher level of trauma care. The operation of a trauma center is often expensive and some areas may be underserved by trauma centers because of that expense. As there is no way to schedule the need for emergency services, patient traffic at trauma centers can vary widely. A trauma center may have a helipad for receiving patients that have been airlifted to

1026-660: Is a specialty unto itself. Adult trauma surgeons are not generally specialized in providing surgical trauma care to children and vice versa, and the difference in practice is significant. In contrast to adult trauma centers, pediatric trauma centers only have two ratings, either level I or level II. Ear, nose, and throat Otorhinolaryngology ( / oʊ t oʊ ˌ r aɪ n oʊ ˌ l ær ɪ n ˈ ɡ ɒ l ə dʒ i / oh-toh- RY -noh- LARR -in- GOL -ə-jee , abbreviated ORL and also known as otolaryngology , otolaryngology   –   head and neck surgery ( ORL–H&N or OHNS ), or ear, nose, and throat ( ENT ) )

1080-466: Is a surgical subspecialty within medicine that deals with the surgical and medical management of conditions of the head and neck. Doctors who specialize in this area are called otorhinolaryngologists, otolaryngologists, head and neck surgeons, or ENT surgeons or physicians. Patients seek treatment from an otorhinolaryngologist for diseases of the ear , nose , throat , base of the skull , head, and neck. These commonly include functional diseases that affect

1134-777: Is limited to confirming and reporting on any given hospital's ability to comply with the ACS standard of care known as Resources for Optimal Care of the Injured Patient. The Trauma Information Exchange Program (TIEP) is a program of the American Trauma Society in collaboration with the Johns Hopkins Center for Injury Research and Policy and is funded by the Centers for Disease Control and Prevention . TIEP maintains an inventory of trauma centers in

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1188-455: Is most commonly moved during this procedure is from the arms, legs, and back, and can come from the skin, bone, fat, and/or muscle. When doing this procedure, the decision on which is moved is determined on the reconstructive needs. Transfer of the tissue to the head and neck allows surgeons to rebuild the patient's jaw, optimize tongue function, and reconstruct the throat. When the pieces of tissue are moved, they require their own blood supply for

1242-681: The National Health Service in its formation in July 1948 and closed in 1993. The NHS now has 27 major trauma centres established across England , four in Scotland , and one planned in Wales . According to the CDC , injuries are the leading cause of death for American children and young adults ages 1–19. The leading causes of trauma are motor vehicle collisions, falls, and assaults with

1296-640: The Shock Trauma Center in Baltimore , Maryland , on July 1, 1966. The R Adams Cowley Shock Trauma Center is one of the first shock trauma centers in the world. Cook County Hospital in Chicago trauma center (opened in 1966). David R. Boyd interned at Cook County Hospital from 1963 to 1964 before being drafted into the Army of the United States of America . Upon his release from the Army, Boyd became

1350-496: The board of trustees ; one hundred other citizens step up as well to provide funding, most notably Pricilla Blake, who provides $ 1,000 to the hospital. In 1893, Ellen Paine was headhunted from Mass General to replace Spratt as superintendent. The hospital trustees made plans to approach the Maine State Legislature to request funding, as over 2/3 of the patients being admitted were from outside of Bangor, but

1404-559: The ACS. These levels may range from Level I to Level IV. Some hospitals are less-formally designated Level V. The ACS does not officially designate hospitals as trauma centers. Numerous U.S. hospitals that are not verified by ACS claim trauma center designation. Most states have legislation that determines the process for designation of trauma centers within that state. The ACS describes this responsibility as "a geopolitical process by which empowered entities, government or otherwise, are authorized to designate." The ACS's self-appointed mission

1458-733: The BC area, "Each year, Fraser Health treats almost 130,000 trauma patients as part of the integrated B.C. trauma system". In the United States, trauma centers are ranked by the American College of Surgeons (ACS) or local state governments, from Level I (comprehensive service) to Level III (limited-care). The different levels refer to the types of resources available in a trauma center and the number of patients admitted yearly. These are categories that define national standards for trauma care in hospitals . Level I and Level II designations are also given adult or pediatric designations. Additionally, some states have their own trauma-center rankings separate from

1512-537: The US, collects data and develops information related to the causes, treatment and outcomes of injury, and facilitates the exchange of information among trauma care institutions, care providers, researchers, payers and policymakers. [REDACTED] A trauma center is a hospital that is designated by a state or local authority or is verified by the American College of Surgeons. A Level I trauma center provides

1566-494: The United States and Canada, otorhinolaryngology is one of the most competitive specialties in medicine in which to obtain a residency position following medical school. In the United Kingdom, entrance to higher surgical training is competitive and involves a rigorous national selection process. The training programme consists of 6 years of higher surgical training after which trainees frequently undertake fellowships in

1620-731: The United States, trainees complete at least five years of surgical residency training. This comprises three to six months of general surgical training and four and a half years in ORL-H&;N specialist surgery. In Canada and the United States, practitioners complete a five-year residency training after medical school. Following residency training, some otolaryngologist-head & neck surgeons complete an advanced sub-specialty fellowship, where training can be one to two years in duration. Fellowships include head and neck surgical oncology, facial plastic surgery, rhinology and sinus surgery, neuro-otology , pediatric otolaryngology, and laryngology. In

1674-404: The clinic staff were reassigned to other positions within their respective health networks. Due to lack of staff, NLEMMC's walk in care location reduced its hours in 2023. In June 2002, NLEMMC was criticized by its own doctors for proposing a change to its bylaws that would give the hospital the ability to discipline or fire doctors who said anything that could "undermine an individual's trust in

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1728-467: The clinical expertise of a Level I institution. It provides 24-hour availability of all essential specialties, personnel, and equipment. Oftentimes, level II centers possess critical care services capable of caring for almost all injury types indefinitely. Minimum volume requirements may depend on local conditions. Such institutions are not required to have an ongoing program of research or a surgical residency program. A Level III trauma center does not have

1782-499: The facial nerve and lateral skull base) Rhinology includes nasal dysfunction and sinus diseases. Facial plastic and reconstructive surgery is a one-year fellowship open to otorhinolaryngologists who wish to begin learning the aesthetic and reconstructive surgical principles of the head, face, and neck pioneered by the specialty of Plastic and Reconstructive Surgery. Sleep surgery encompasses any surgery that helps alleviate obstructive sleep apnea and can anatomically include any part of

1836-470: The facilities. Mabel Hammons, a nursing student, recalls that "the always immaculate little building had an extra going over; nurses wore their best uniforms, patients were implored to smile, look comfortable and not require bedpans while the Legislature was here." A new building to ease overcrowding and provide additional surgical theaters was proposed, and $ 20,000 was set aside for the project. Work on

1890-441: The facility must have an after-hours trauma response protocol. A facility can be designated an adult trauma center, a pediatric trauma center, or an adult and pediatric trauma center. If a hospital provides trauma care to both adult and pediatric patients, the level designation may not be the same for each group. For example, a Level I adult trauma center may also be a Level II pediatric trauma center because pediatric trauma surgery

1944-637: The first hospital to be established specifically to treat injured rather than ill patients, was the Birmingham Accident Hospital , which opened in Birmingham , England in 1941 after a series of studies found that the treatment of injured persons within England was inadequate. By 1947, the hospital had three trauma teams , each including two surgeons and an anaesthetist, and a burns team with three surgeons. The hospital became part of

1998-503: The first shock-trauma fellow at the R Adams Cowley Shock Trauma Center, and then went on to develop the National System for Emergency Medical Services , under President Ford . In 1968 the American Trauma Society was created by various co-founders, including R Adams Cowley and Rene Joyeuse as they saw the importance of increased education and training of emergency providers and for nationwide quality trauma care. According to

2052-513: The foundation for the building began soon after. The board of trustees voted to tear down the existing Hospital and use its materials to help reduce the cost of constructing the new, larger building. Another doctor, Bertram L. Bryant, specializing in " pathology and bacteriology ", was hired into the medical team as well. The new ward was opened in October 1899. Extra trolley cars had to be put into service in Bangor and Old Town to help transport

2106-757: The founder of the Trauma Unit at Sunnybrook Health Sciences Centre in Toronto , Ontario, Marvin Tile , "the nature of injuries at Sunnybrook has changed over the years. When the trauma centre first opened in 1976, about 98 per cent of patients suffered from blunt-force trauma caused by accidents and falls. Now, as many as 20 per cent of patients arrive with gunshot and knife wounds". Fraser Health Authority in British Columbia , located at Royal Columbian Hospital and Abbotsford Regional Hospital, services

2160-426: The full availability of specialists but has resources for emergency resuscitation, surgery, and intensive care of most trauma patients. A Level III center has transfer agreements with Level I or Level II trauma centers that provide back-up resources for the care of patients with exceptionally severe injuries, such as multiple trauma. A Level IV trauma center exists in some states in which the resources do not exist for

2214-533: The highest and Level III (Level-3) being the lowest (some states have four or five designated levels). The highest levels of trauma centers have access to specialist medical and nursing care, including emergency medicine , trauma surgery , critical care , neurosurgery , orthopedic surgery , anesthesiology , and radiology , as well as a wide variety of highly specialized and sophisticated surgical and diagnostic equipment. Lower levels of trauma centers may be able to provide only initial care and stabilization of

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2268-412: The highest level of surgical care to trauma patients. Being treated at a Level I trauma center can reduce mortality by 25% compared to a non-trauma center. It has a full range of specialists and equipment available 24 hours a day and admits a minimum required annual volume of severely injured patients. A Level I trauma center is required to have a certain number of the following people on duty 24 hours

2322-470: The hospital the same year, and later the hospital was converted to electric lighting and laundry facilities were added in the basement. In 1896, the name of the hospital was changed to Eastern Maine General Hospital, to reflect the fact that most of its financial support came from the state, not the city. An addition was constructed to the Mace House, a horse shed was added, "a very commodious bathroom"

2376-451: The hospital's nurse-to-patient ratio. The hospital has a track record of poor relationships with the nurse's union; nurses had previously threatened to strike in 2007 over the same issue, but the strike was called off two days after the strike warning had been issued to the hospital. The union threatened a strike in late 2010, again citing failed discussions regarding nurse-patient ratios and outdated health insurance coverage. The nurses took up

2430-529: The hospital. In some cases, persons injured in remote areas and transported to a distant trauma center by helicopter can receive faster and better medical care than if they had been transported by ground ambulance to a closer hospital that does not have a designated trauma center. Trauma centres grew into existence out of the realisation that traumatic injury is a disease process unto itself requiring specialised and experienced multidisciplinary treatment and specialised resources. The world's first trauma centre,

2484-419: The large crowds, who came to take tours of the new facilities. The first interns were appointed soon after, in 1900. The hospital also purchases its first ambulance. There was a 50% increase in the number of admitted patients between 1900 and 1901, bringing the number of patients admitted in 1901 to 799. The same year, a separate building was constructed to house contagious disease patients. Overcrowding became

2538-696: The plans were abandoned to allow for the money to fund the construction of the Eastern Maine Insane Asylum , now the Dorothea Dix Psychiatric Center. Instead, it purchased the Mace house with the pledges paid by the trustees. However, overcrowding quickly becomes an issue, and to free up interior beds, the hospital pitches a tent during the summer to provide a recovery room for male outpatient surgery patients. The hospital staff divided itself in two in October 1895;

2592-819: The senses and activities of eating, drinking, speaking, breathing, swallowing, and hearing. In addition, ENT surgery encompasses the surgical management of cancers and benign tumors and reconstruction of the head and neck as well as plastic surgery of the face, scalp, and neck. The term is a combination of Neo-Latin combining forms ( oto- + rhino- + laryngo- + -logy ) derived from four Ancient Greek words: οὖς ous ( gen. : ὠτός otos ), "ear", ῥίς rhis , "nose", λάρυγξ larynx , "larynx" and -λογία logia , "study" (cf. Greek ωτορινολαρυγγολόγος, "otorhinolaryngologist"). Otorhinolaryngologists are physicians ( MD , DO , MBBS , MBChB , etc.) who complete both medical school and an average of five–seven years of post-graduate surgical training in ORL-H&N. In

2646-533: The stores in 2009. The stores were located in Bangor, Brewer, Palmyra, Augusta, Waterville, and Presque Isle. The clinics were an attempt to improve rural access to healthcare. Healthcare at the Wal-Mart clinics was limited to simple health problems, such as colds ; ear, nose, and throat issues; and minor burns. All of the clinics except the Waterville clinic were closed in 2011 due to low patient volume, and

2700-480: The upper airway. Microvascular reconstruction repair is a common operation that is done on patients who see an otorhinolaryngologist. It is a surgical procedure that involves moving a composite piece of tissue from the patient's body and to the head and/or neck. Microvascular head-and-neck reconstruction is used to treat head-and-neck cancers, including those of the larynx and pharynx, oral cavity, salivary glands, jaws, calvarium, sinuses, tongue and skin. The tissue that

2754-411: The ward began in 1909, and the ward opened on January 1, 1910. The hospital also took the opportunity to install its first set of x-ray equipment. In late 2012, the NLEMMC board of directors gave the final approval to a $ 287 million expansion project, to be taken on by Morris Switzer , a healthcare architecture firm. The expansion consists of a $ 247 million building renovation and expansion project and

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2808-661: Was "A"-rated by Leapfrog Group , indicating a low risk of patient injury from medical error. During the COVID-19 pandemic, this rating was dropped to a C. In 2022, NLEMMC was the only Maine hospital reviewed by Leapfrog Group to have not improved their score from pandemic lows. Level II trauma center A trauma center , or trauma centre , is a hospital equipped and staffed to provide care for patients suffering from major traumatic injuries such as falls , motor vehicle collisions , or gunshot wounds . A trauma center may also refer to an emergency department (also known as

2862-411: Was built on the second floor, and the outside of the facilities were improved. Dr. Harry Butler, an ear, nose, and throat surgeon, was also hired on. Donations to the hospital this year were expansive, including barrels of apples, canned fruit, fresh flower, and at Christmastime, holiday cakes and gifts. The hospital was chartered in 1897 by the Maine State Legislature , and a committee came to inspect

2916-491: Was later sold to the Felician Sisters and became St. Joseph's Hospital , which still exists. Ida Washburne, another Mass General employee, stepped up to take her place. Later, in 1907, the state legislature approved a grant of $ 15,000 to the hospital for the construction of a children's ward, provided that the hospital raises $ 25,000 on its own. Two private citizens donate the required $ 25,000 in 1908. Construction of

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