Community Regional Medical Center is licensed for 685 inpatient beds and is home to the UCSF Fresno residency programs. It is the one of the largest and busiest hospital in the state. The Trauma/Critical Care Building includes a 58,000 square foot, 70-bed emergency department as well as state of the art Burn unit, critical care units, cardiac cath lab, and two 64-slice CT scanners (one in the ED). The annual ED census is over 110,000, making it one of the busiest in California.
CRMC is the only Level 1 Trauma Center serving a several county area of Central California. It is a major teaching institution with full-time faculty physicians and a house staff of 300. In addition to emergency medicine, there are approved residency training programs in: internal medicine, surgery, obstetrics and gynecology, pediatrics, family medicine, psychiatry, oralmaxillofacial surgery, orthopaedic surgery and dentistry. We currently have fellowships in pulmonary critical care, cardiology, infectious disease, palliative care, gastroenterology, acute care surgery, surgery critical care, minimally invasive surgery, wilderness medicine, EM ultrasound, EM medical education, community pediatrics, hematology/oncology, hospice and palliative medicine, maternal child health, and sleep medicine. All attending physicians affiliated with the residencies are UCSF faculty. Two UCSF Medical School Associate Deans are based at the UCSF Center for Medical Education and Research which also houses local UCSF Fresno staff, departmental offices, the medical library, an auditorium, multiple conference rooms, and a medical simulation lab.
Our Emergency Department is among busiest in California.
| Average Number of Patients Seen in the Emergency Department* | 110,000 |
| Total Emergency Department Admissions* | 22,300 |
| Size of the Emergency Department (Square Footage) | 56,000 |
| *2017 OSPHD Data, Hospital Emergency Department - Encounters by Facility |
CRMC’s ED contains three major trauma rooms with dedicated CT and radiology services, a cardiac/critical care pod, a major medical area, a minor treatment area, ophthalmology and ENT rooms, dental room, several family rooms, ED ultrasound machines, a law enforcement area, a sexual assault center, a secure behavioral care unit, offices, a conference room, clerical and nursing support space, dedicated laboratory and respiratory services, a paramedic and parkmedic communication base station, and two helicopter landing pads, among other services and facilities.
The emergency medicine residents and staff are responsible for the initial evaluation and treatment of the majority of ED patients. Midlevel providers help staff the lower acuity areas. Academic and non-academic EM clinicians also see patients primarily. Emergency medicine residents also staff these areas and all medical care there is supervised by attending physicians. All patients and visitors are screened by dedicated security personnel stationed in the ED.
Most critically ill and injured patients in Fresno are brought to CRMC. Blunt trauma victims outnumber penetrating trauma victims (80% & 20% respectively). Pediatric trauma patients are transported to either CRMC or Valley Children’s Hospital. Frequently, those suffering a mishap in the surrounding mountain and rural areas ore transported to us via helicopter – either by Skylife aeromedical personnel or by the California Highway Patrol.
CRMC is a paramedic and parkmedic communication base station handling thousands of emergency medical systems radio calls monthly. MICN’s and emergency medicine residents and faculty direct prehospital care via protocol over the radio. The Department of Emergency Medicine is actively involved in training and supervising paramedics and parkmedics and our residents play a substantial role in this process. Members of our faculty serve as medical directors for the Fresno County and Madera/King Counties EMS systems, the Sequoia/Kings Canyon Parkmedic Program and the local helicopter and ambulance services.
Other major teaching and patient care facilities include: a burn unit, a coronary care unit, a surgical ICU, a medical ICU, a dialysis center, a hyperbaric chamber, and an acute psychiatric intervention center. Consultative support is continuously available from: surgery and all its subspecialties, oral maxillofacial surgery, dentistry, obstetrics and gynecology, pediatrics, internal medicine, family medicine, cardiology, ophthalmology, neurology, gastroenterology, and radiology. Ancillary support—from RNs and LVNs, technicians, aides, clerks, social workers and others—is excellent. Physicians do not start peripheral IVs, do EKGs, pass nasogastric tubes, etc.
CRMC serves the population of Fresno County and its surrounding areas. Our patient population is culturally diverse and reflective of the area’s population as a whole with approximately 90 different ethnic groups represented. About 50% of our patients are Hispanic, and approximately 10% speak only Spanish. Interpreters and interpreting services are available on an ongoing basis to assist in the care of all patients.
