Christiana Opens Emergency Medical Unit in Middletown, DE; New Health Option for Southern Cecil County
The renowned Christiana Care Health Systemâs hospital and trauma center in Delaware recently opened a satellite âEmergency Departmentâ in Middletown that provides a new source of medical services to southern Cecil County, Maryland residentsâbut local ambulance transport in emergencies is still a while away.
The new $34 million, 36,500 square foot emergency medical services facility, located near the intersection of Brick Mill Road and Route 299 (adjacent to the Giant Food shopping center on the outskirts of town near Route 1) opened a few weeks ago in what hospital officials described as a low-key, âsoftâ opening on April 16. But the facility is already exceeding estimates of patient demand for services and is expected to move from âwalk-inâ patients only to ambulance-transported patients in the next few months.
The hospital also has a helipad for helicopter transport of critically ill patients from the Middletown facility to the main Christiana Care hospital and trauma center in northern New Castle County, DE. (Christiana Care has consistently won top honors in national evaluations of state and regional hospitals.)
Right now, the Middletown facility provides new closer-to-home medical services to southern Cecil County âan area that has been characterized by state and federal agencies as a âmedically under-served area.â In the next few months, the Middletown facility may provide a closer alternative for ambulance-transported patients than the current primary option of Union Hospital in Elkton, MD. Union is not a designated trauma center and patients with life-threatening conditions, including heart-attack or stroke, are routinely transferred from Union to Christianaâs main hospital.
In an interview with Cecil Times, Linda Laskowski Jones, a nurse with more than 30 years experience in trauma and emergency care and the Vice President of Emergency and Trauma for Christiana Care Health System, said, âWe decided to do a soft-openingâ so as to work out any possible kinks in the brand-new operation in Middletown. The facilityâs staff includes experienced, board-certified emergency medicine doctors and nurses. Initial estimates of patient-loads were about 40 people per day, she said, but in fact actual usage has been almost twice that figure.
Right now, the Middletown facility has not been accepting ambulance-transported patients and instead is focusing on walk-in patients. But, Jones added, the Middletown ER expects to be ready to handle ambulance-transported patients âby late June or early July.â
In the interim, she said, the hospital is working with Delaware emergency services to co-ordinate ambulance and emergency communication systems. She said the facility has not yet initiated discussions with Cecil County, MD for emergency transport arrangements.
âIt really will be up to those services,â she said, to âseek guidanceâ on whether the local ambulance services will be willing to interact across the local state lines to bring patients to Middletown.
But for many southern Cecil County residents, the Middletown facility provides a top-flight source of medical care, with a shorter transport time for care than the Elkton hospital option.
Meanwhile, Jay Pardee, Chief of the Cecilton Volunteer Fire Companyâone of the closest Cecil County ambulance services to the new Middletown facilityâ said that âas of right now, weâve been informed that they are not yet ready to handle an emergency ambulance.â
So patients transported by the companyâs âbasic life supportâ (BLS) ambulances will be taken to Union Hospital in Elkton or the Kent County hospital in Chestertown as the closest full hospital facilities, under existing protocols. (Neither hospital is a trauma center.)
Critical cases requiring âadvanced life supportâ (ALS) provided by Cecil Countyâs three government-operated paramedic stations, including the nearby Chesapeake City station, function under separate protocols, Pardee noted. For example, trauma cases are transported to the nearest trauma centersâChristianaâs main New Castle County hospital in Delaware or the University of Marylandâs Shock-Trauma unit in Baltimore, which may involve Maryland State Police MEDEVAC helicopter transport.
In the future, Pardee said, the southern Cecil fire company would like to be able to utilize the services of the Middletown emergency center since it is closer for many patients and eliminates potential concerns about conditions on the Chesapeake City bridge on Route 213 that is the primary road access from southern to northern Cecil County.
âIt would be a big helpâ to have a Middletown option, Pardee said. His company also serves Warwick, which is adjacent to the state line and a virtual hop and skip to the Middletown facility. Less time on the road for BLS ambulance runs would mean greater availability of local ambulances to handle more calls for service.
Southern Cecil County fire companies, especially the Cecilton unit and the nearby Hackâs Point unit in Earleville, have been trying to get help from the Cecil County government for well over a year to address slow response times for ambulance calls in the area, due to problems in these low-population areas in providing sufficient numbers of volunteers during daytime hours to make ambulance runs.
The two units initially asked for financial help to hire paid staffers during the daytime hours, at an initial total cost of $100,000, but subsequently pared down the figure to $60,000. But the former County Commissioners did not provide that aid, and the new Fiscal 2014 budget proposed by County Executive Tari Moore did not specify financial help for the south county volunteersâ ambulance services.
(Her budget did propose hiring two additional paramedics employed by the county government, but Richard Brooks, the countyâs Director of Emergency Services, previously told Cecil Times he didnât know which of the countyâs three stations — two of which are located above the Canal–would receive the extra staffing.)
âItâs still a huge work in progress,â Pardee said of aid requested by his and the Hackâs Point fire/ambulance companies. And itâs become even more complex with the shift to Charter government, he said. An EMS Advisory Board is willing to âwork with us,â he said, but the south county units âcanât afford the costs like the bigger fire companiesâ in the northern areas of Cecil County.
When the Middletown facility is ready to handle ambulance-delivered patients in the near future, there may still be questions to be answered by Cecil Countyâs Emergency Services department on interpretations of existing protocols for patient transport. ( A call by Cecil Times a week ago to Brooks about the Middletown option has not yet yielded a response.)
Many southern Cecil County residents will be watching to see if they are afforded, or denied, new optionsâand county aidâto provide for appropriate emergency medical services.