It was a day like any other at the family’s ranch in Sanger, said Nicole Ainger … until it wasn’t.

Her 10-year-old daughter Ashlyn was at the barn riding horses with friends. That’s when Ashlyn’s horse stepped on a sprinkler, spooked, and threw Ashlyn to the ground — accidentally kicking her head. Ainger then got the panicked call from her friend.

She raced to the barn and found her daughter bleeding and unconscious.

“It was surreal … this is not happening,” Ainger thought. “We need a miracle right now.”

The blow left Ashlyn with life-threatening injuries. She was rushed to Table Mountain Rancheria Trauma Center at Community Regional Medical Center in Fresno — the only Level I trauma center between Los Angeles and Sacramento. 

Within 30 minutes of arriving, Ashlyn was in surgery with a multi-specialty team working quickly to save her life.

The incredibly fast response, the number of specialists waiting to treat Ashlyn — that’s what it means to be a Level I trauma center and why Community Regional is such a valued asset to the health and well-being of millions in our Valley.
 

Not all ERs are alike

Ainger witnessed firsthand the difference a Level I trauma center makes for those with traumatic injuries or illnesses. The highest level of care awaited Ashlyn as she came through the doors.

“If she hadn’t gone there, it would’ve been a different story … For trauma, that’s the place to go,” Ainger said.

Ashlyn made a full recovery after her hospital stay, despite facial and traumatic brain injuries including bone fractures and a huge gash on her forehead. Now she has a small scar as a reminder.

“I’m forever grateful for the lifesaving efforts made by the team at Community Regional,” Ainger said.

Community Regional’s trauma service area covers 15,000-square-miles and is one of 16 Level I trauma centers in the state. By volume, it’s the busiest trauma center in California, according to the California Department of Health Care Access and Information (HCAI), and sees more than 4,200 trauma patients each year. 
 

What is a Level I trauma center?

The American Trauma Society describes a Level I trauma center as a hospital that includes 24-hour in-house coverage by general surgeons and prompt availability of care in specialties such as orthopedic surgery, neurosurgery, anesthesiology, emergency medicine, radiology, internal medicine, plastic surgery, oral and maxillofacial surgery, pediatric and critical care.

Trauma center verification is an evaluation process done by the American College of Surgeons (ACS) to evaluate and improve trauma care. Community Regional’s most recent verification was in March 2023. 

The ACS verifies the presence of resources the hospital must provide, including readiness with neurosurgeons and cardiac surgeons on call 24/7, resources such as high-tech imaging and operating rooms, policies, patient care quality and performance improvement processes.
 

A higher level of care for patients … and other Valley hospitals

San Luis Obispo resident James Fuller was out enjoying a day with his friends riding dirt bikes. The next thing he knew, a head-on collision left him fighting for his life.

“We were both probably doing 40 or 50 miles an hour,” Fuller said. “I was tumbling through the air.”

Fuller was thrown 30 feet and, after that, things got blurry. 

“They said three more minutes out there and I probably would have bled out,” he said.

Fuller was stabilized at a local hospital on the Central Coast and then quickly transferred to Community Regional where specialists were waiting to treat his injuries.

The accident left him needing five blood transfusions and two complicated surgeries to fix  his broken leg and pelvis. Fuller suffered life-threatening injuries even though he had been wearing full protective gear including a helmet and boots.

“I woke up 10 hours later and they said they fixed me up with some bolts and pins and screws,” Fuller said. After his discharge, Fuller spent months in recovery and rehabilitation.

More than 4,000 patients a year are transferred from surrounding area hospitals to Community Regional to receive specialty care like Fuller did. Community Regional has highly skilled teams who are prepared at a moment’s notice to care for patients with traumatic injuries or illnesses like his.

Other hospital emergency departments in Central California don’t have as much access to these care specialties or are unable to provide the extensive resources required for a level I trauma designation, so they rely on Community Regional to take patients needing a higher level of care.
 

The region’s only ‘verified’ burn center

Community Regional is also home to the Leon S. Peters Burn Center — the only verified burn center from Los Angeles to Sacramento, and a place 23-year-old Pradnya Bergdahl knows all too well. 

She spent months healing and going through painful rehabilitation there. When she was 10 years old, Bergdahl was accidentally burned while making ramen noodles on the stove top.

“I was on a step stool, I had twisted my front half of my body to talk to my sister who was already at the table eating and my mom's back was towards me,” she said. “When I turned, my shirt caught in the stove and caught on fire.”

Bergdahl had second- and third-degree burns on her torso and had to have a skin graft on her back.

“I was just blessed to have a burn center close to home because I didn't have to travel far away for treatment. And that's both for outpatient and inpatient,” Bergdahl said. “I think it's super important that they were able to treat a pediatric burn … and that they were just as equipped and knowledgeable to treat a child.”

Today, Bergdahl celebrates her “burn-a-versaries” and spent her last one at Community Regional with her physical therapist Ace Santoyo and burn surgeon William Dominic. She brought treats for all the caregivers and the message that a burn injury doesn’t have to stop you from living life to its fullest.

“Thank you for helping me get back to a place where I’m living a normal and functioning life again,” Bergdahl said. “It’s just so nice to show them who I am as a person … because of your burn injury, you don’t always get to make a great first impression … when you’re in so much pain.”

The Leon S. Peters Burn Center at Community Regional is one of 13 burn centers in the state and the only verified burn center in the region. The American Burn Society says verification provides a true mark of distinction for a burn center and is an indicator that it provides the highest quality of patient care from the time of injury through rehabilitation.

More than 800 patients were treated at our burn center in 2022, of which 32% were pediatric patients like Bergdahl. 
 

Vital services threatened by looming seismic mandate 

As the flagship hospital of Community Health System, Community Regional is the place that people of Central California depend on most for trauma, burn and other high-level care when they need it most. 

Our partnership with the University of California San Francisco Medical School — one of the top medical schools and research institutions in the nation — provides access to some of the brightest and most forward-thinking medical specialists in the country. But without relief from the upcoming seismic standards, vital services and specialties are threatened:
 

• The only Level I Trauma and comprehensive burn center.
• Neuroscience specialties with clinical experts in brain tumors, stroke, dementia, Parkinson’s disease, Alzheimer’s and more.
• Comprehensive cardiology services, offering more advanced cardiac treatment options than any other hospital in the Valley and the only cardiology, pulmonary and interventional cardiac fellowship training programs in the region with the UCSF Fresno Medical Education Program.
• One of the busiest high-risk birthing centers in California with the largest Level 3 neonatal intensive care unit in the Valley. Our combined expertise in both adult and newborn medicine makes our hospital the only one in the area where recovering mothers and their critically ill babies can stay together for the treatments they need.

Despite the challenges, Community will continue doing all we can to serve people like Ashlyn, James and Pradnya, and all those who walk through our doors.