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Soon just two hospitals in Maine will provide neurosurgical trauma surgeries, as CMMC suspends the service

Courtesy of CBS 13
via the Bangor Daily News
Central Maine Medical Center in Lewiston.

Central Maine Medical Center in Lewiston will no longer provide 24 hour coverage for treatment of neurosurgical traumas, such as head injuries, and will soon suspend the service altogether. That will leave just two hospitals in the state to provide the service. The rupture in the state's trauma system prompted Maine's board of Emergency Services to hold an emergency meeting on Tuesday. The committee's efforts were hampered by a lack of data from CMMC.

Central Maine Medical Center has been trying to recruit neurosurgeons, says Dr. Jason Krupp. He's the chief physician executive of CMMC's parent company, Central Maine Healthcare. But that's proven difficult he says, and the recent retirement of a neurosurgeon means the Lewiston hospital can now only offer sporadic coverage to care for trauma patients with head and spinal chord injuries.

'We have nothing left from a coverage standpoint in December, and will have seven days of coverage in January," Krupp says.

And after 60 days, Krupp says, CMMC will suspend the service. If a patient needs neurosurgical trauma care, he says CMMC will stabilize them and transfer them to either Maine Medical Center in Portland or Northern Light Eastern Maine Medical Center in Bangor. The loss of neurosurgical care at the Lewiston hospital comes at a time when hospitals across the state are already facing capacity constraints due to the Covid-19 pandemic. And it creates an additional challenge for ambulance workers who need to find appropriate care for patients.

During a virtual meeting of the Maine EMS Trauma Advisory Committee Tuesday, emergency service providers and hospital officials tried to figure out a plan going forward for Maine's trauma system. But when CMMC officials were asked to provide data to help the committee make decisions, Krupp could only provide limited information.

"I can say in general the number of neurosurgical cases, from a trauma standpoint, that come to Central Maine Medical Center make up 10% or less of our calls here," Krupp says.

In the absence of specific numbers, committee members like Julie Ontengco of Maine Medical Center's Trauma Program said it was impossible to create a meaningful plan and suggested an additional meeting was necessary to comb over data.

"And figure out the best way to support each other through this. This isn't going to be easy for any of us," Ontengco says.

One central issue on the table is whether hospitals should continue to transfer neurosurgery trauma patients to CMMC. After roughly 90 minutes of discussion, a majority of committee members ultimately supported a motion that temporarily halts such transfers. A smaller committee will meet again in two weeks to review data and make a long-term recommendation. The motion also directs the Maine Medical Direction and Practices Board to issue guidance to EMS workers on where to bring neurosurgery trauma patients that need immediate lifesaving care. That guidance could come Wednesday, after the Board's monthly meeting.