By: Kathy Hubbard
Many of us have only ever witnessed medical traumas on our television sets. That’s the good news. The better news is that with a whole lot less chaos and drama, providers in the emergency department at Bonner General Health not only know how to expertly and professionally care for those suffering trauma, heart attacks (aka STEMI, I’ll explain later) and strokes, they work tirelessly to make the system work more efficiently and to improve outcomes.
Let me explain. The State of Idaho developed the Time Sensitive Emergency (TSE) system to address these top three preventable causes of death. This collaborative approach includes hospitals, emergency medical services agencies, public health districts, and the Idaho Military Division.
The Department of Health and Welfare’s website says, “The Idaho TSE System is molded on evidence-based care that addresses public education and prevention, 911 access, response coordination, pre-hospital response, transport, hospital emergency/acute care, rehabilitation, and quality improvement. The TSE program creates a seamless transition between each level of care and integrates existing community resources to improve patient outcomes and reduce costs.”
BGH voluntarily applied for and met the criteria for TSE designation. The designation is approved for three years and is renewable provided they remain in compliance with the designation criteria and rules of the Idaho TSE System Council.
“I attended the [emergency department] committee meeting last week where they talked about traumas,” BGH Marketing Manager Kristin Carlson told me. “The committee includes managers of the lab, Diagnostic Imaging, Surgery, Cardiopulmonary and nursing units, along with the Emergency physicians, management and staff. They meet to review their whole process for patients and look to see where we can make any changes or improvements in response to Time Sensitive Emergencies. I was impressed by the collaboration among this group and their commitment to caring for our community.”
Marian Martin, BSN, RN, CEN is the Director of Emergency Services and Trauma Program Manager/STEMI Coordinator at BGH. She told me that motor vehicle crashes are the top cause of high priority trauma cases. Next up are falls.
“86 percent of Idahoans wear their seat belts, but 40 percent of passenger motor vehicle occupants killed in 2023 were not wearing theirs. Seat belts reduce risk of death by 45 percent and risk of serious injury by 50 percent.
“E-bikes are associated with a growing number of serious injuries nationwide, particularly among children and adolescents. Wear your helmet and follow the road rules. Supervise children and adolescents. Avoid alcohol when riding,” she said.
STEMI stands for ST-Elevation Myocardial Infarction. It’s the most severe type of heart attack. It occurs when a coronary artery is completely blocked, causing significant heart muscle damage. Martin said that BGH has seen twenty heart attack patients in 2025, which is about the same number they saw in 2024. The ER works closely with Bonner County EMS and Life Flight to quickly transfer those patients to a hospital with advanced cardiac care abilities.
“Call 911 or get seen in the emergency department as soon as possible if you have heart attack symptoms such as chest discomfort in the center of your chest that lasts more than a few minutes or comes and goes and comes back. Shortness of breath, nausea, and sweating can also be signs associated with a heart attack,” Martin advised.
Ryan Kerouac, RN, CEN, is the Emergency Department Manager and Stroke Coordinator. He said that BGH has a successful stroke program that meets all American Heart Association and Idaho state guidelines.
“Our biggest problem is that patients arrive after we are able to intervene. When someone is having a stroke, we have a 4.5-hour window from when the symptoms started to give them a medication that dissolves clots. This medication has shown to make a big difference in patient recovery, in some cases completely eliminating all symptoms and in a lot of cases decreasing the amount of disability. A lot of people notice the symptoms and wait too long before coming to the ER and are not a candidate for the medication,” he said.
He said that too often people suffer from stroke symptoms, then go back to bed to see if they feel better later. This is called wake-up stroke. If you wake up with symptoms, call 911 immediately. The medications cannot be administered if the ER provider doesn’t know when symptoms began.
Once again, if you’ve experienced a trauma, have fallen, have symptoms associated with heart attacks and/or strokes, call 911. The Emergency Department is always open.
Kathy Hubbard was a charter member of Bonner General Health Foundation. She can be reached at [email protected]. This article was written for publication in the Bonner County Daily Bee on December 17, 2025.