Yes, it would be nice to have a resident neurosurgeon, a resident interventional cardiologist, a resident neonatologist, a standby air ambulance and so on but not practical nor economically feasible.
In the Cayman surgical community you have a skilled general surgeon (I know for a fact) who has in the past saved a closed head trauma life by doing ‘burr holes’.
What could/should be suggested to the two hospitals is that when the hospitals are contemplating hiring a new surgeon they should require that person to have some trauma skills because amongst those skills is the ability to treat a subdural or epidural bleed from trauma.
If the GT Hospital would get on the telemedicine programme I have been encouraging for several years you could have an immediate neurological/surgical consult right from your ER/CT room to Baptist. At least the diagnosis could be established.