FRANKFORT, Ky. (AP) -- With the help of her father, Christi Teitloff made her way to the front of a conference room crowded with doctors and paramedics to show just how important their work is.

The 32-year-old, limping slightly but wearing a broad smile, beat the odds by surviving a horrific car crash in rural Kentucky, overcoming a long list of ailments that included a severe brain injury, ruptured spleen, collapsed lung, broken hip and three months in a coma.

Doctors pushing for a statewide trauma system say Teitloff was fortunate to have survived her life-threatening injuries in a remote part of the state.

Dr. William Barnes, a western Kentucky trauma surgeon, said people critically injured in rural areas are 50 percent more likely to die than those injured in urban areas with major hospitals.

“That puts everybody in western Kentucky and their children and their grandchildren in grave danger,” Barnes said.

The American College of Emergency Physicians lists Kentucky among 14 states without trauma systems for routing critically injured people to the closest appropriate trauma center.

People in far eastern and western Kentucky towns have no nearby trauma centers and have to be transported to distant cities for treatment, said Barnes, a Livingston County physician. He is among a group of doctors urging lawmakers to create a statewide trauma system that would ensure the most critical patients be moved as quickly as possible to big-city hospitals that can provide necessary medical care.

Kentucky has only three designated trauma centers—at the University of Kentucky and University of Louisville medical centers and at Taylor Regional Medical Center in Campbellsville.

Dr. Andrew Bernard, a trauma surgeon at the University of Kentucky, said people give little thought to the issue until they or a family member are critically injured. Even so, Kentucky needs to create regional trauma centers in outlying towns like Pikeville and Paducah, which would allow patients to stay closer to home and reduce the amount of time they spend in ground and air ambulances, Bernard said.

Under current protocol, every trauma victim in outlying communities gets transported to big-city hospitals, whether in Kentucky or an adjoining state.

Barnes said people have the misconception, primarily from watching prime-time television, that every hospital emergency room has the latest technology and is capable of handling whatever medical emergencies arise.

“In reality, that is not true,” he said.

Dr. Jeff Violette, an emergency physician from Lexington, said

That makes it all the more important to have an established protocol that would get the most seriously injured people to top-tier trauma centers fast.

“You’ve got about an hour to make a difference in saving lives in a serious injury,” Violette said.

Legislation introduced last week by state Rep. Mary Lou Marzian, D-Louisville, would require the state to create the Kentucky Office of Trauma Care that would oversee the development of a cooperative system between emergency doctors, hospitals and paramedics.

In the bill, Marzian cited the importance of providing medical care within the “golden hour,” the hour immediately following traumatic injury. To ensure that happens, Marzian is calling for the creation of the statewide trauma care system.

Trauma centers see large numbers of uninsured patients and face high malpractice insurance premiums. That, Marzian said, discourages them from operating full-scale trauma centers.

Because of that, Marzian is proposing the creation of a trauma fund to provide financial assistance for creating new trauma centers, for operating the Office of Trauma Care, to cover the cost of uncompensated care provided by hospitals and physicians.

Ashlee M. Melendez, executive director of the Kentucky Chapter of the American College of Emergency Physicians, said the bill intentionally requests no specific level of funding.

“My hope is that they pass this bill, and then we can work on how best to fund it,” she said.

Teitloff, who was 16 when she had her car crash, urged officials to do what’s necessary to provide medical care to trauma victims.

Barnes, who treated Teitloff, said she survived because the local hospital had a trauma center. That’s no longer the case.

“It’s scary,” said Teitloff’s mother, Mikey. “If this had happened today, she probably wouldn’t have survived.”

Barnes said rural trauma patients are likely to spend hours being shuttled about, first in a ground ambulance to a local emergency room to be assessed by the physician on call, then put on a helicopter and sent to an urban hospital. He said the transfers, plus the local emergency room triage, often taken four to six hours.

“Where is that golden hour?” He asked.

Dr. Kraig Humbaugh, a physician at the state Department for

Public Health, said traumatic injuries are the leading cause of death for Kentuckians under 45. In most cases, those injuries are the result of car crashes and falls.

Some rural Kentucky counties, Humbaugh said, have car crash rates three times higher than urban counties.

Paramedic Mark Harrison of Benton, president of Kentucky Ambulance Providers Association and director of the Marshall County ambulance service, said routing patients to local hospitals, then to Louisville or Nashville, can take much too long.

“It’s a logistical nightmare,” Harrison said. “Without a statewide plan, everyone is really on their own.”

Melendez said if paramedics and ambulance personnel know what services are being offered at each hospital at any given time they would know where to transport patients. And a state trauma system, she said, would make that information available.

Under the current, uncoordinated approach, paramedics have to gather that kind of information themselves.

“It works when it works, and when it doesn’t work, it’s bad,” Melendez said. “It really depends on the luck of the draw."

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   The legislation is House Bill 152.