Trauma

What is a Trauma Center?

A trauma center is an area of a hospital with the equipment and staff to treat the most critical injuries that put the patient’s life is in immediate danger. Trauma centers are usually located within the hospital emergency room.

Who Needs Trauma Care?

Trauma centers treat a vast variety of catastrophic injuries such as:

  • car and motorcycle crashes
  • drowning
  • gunshot wounds
  • serious falls
  • severe burns
  • spinal cord injuries
  • stab wounds
  • traumatic brain injuries
  • violent assaults

Trauma Center Levels

There are 5 levels of trauma centers: I, II, III, IV and V (or 1, 2, 3 ,4 and 5). In all states, Level I is the highest. In some states, Level III is the lowest. Some states have five trauma center designations, and in these states Level V is lowest.

A trauma center’s level is determined by a two-step process: designation and verification. The designation guidelines vary from state to state, based on the trauma resources available at the hospital and the number of adult trauma patients admitted each year. There are additional criteria for pediatric trauma centers.

The American College of Surgeons (ACS administers the trauma center Verification, Review, and Consultation Program, a process designed to help hospitals evaluate and improve the quality of trauma care. After confirming that a trauma center has all the resources in place for a particular level designation as outlined in the program’s standards, ACS issues a certificate of verification that is valid for three years.)

The highest-level trauma centers can provide a wide range of emergency medicine, specialized surgeries and critical care services using advanced diagnostic and surgical equipment. Lower-level trauma centers may only provide initial care for a traumatic injury then arrange for the patient to be transferred to a higher-level trauma center.

 

Type of Trauma Levels

Level I trauma centers provide comprehensive care for every aspect of injury, from prevention to rehabilitation. A Level I trauma center is a regional resource that provides leadership, teaching, research and outreach efforts to help drive innovation in trauma care. 

The Level I trauma center team is available 24 hours a day and includes:

  • emergency and critical care physicians and nurses
  • surgeons in many trauma surgery specialties, including general surgery, neurosurgery, orthopedic surgery, oral/maxillofacial surgery and plastic/reconstructive surgery
  • specialists in a broad spectrum of medical fields such as anesthesiology, internal medicine and radiology

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Level II trauma centers provide 24-hour emergency medicine and critical care, as well as immediate access to general surgeons and specialists in orthopedic surgery, neurosurgery, anesthesiology and radiology. Some patients, such as those needing cardiac or microvascular surgery, may be transferred to a Level I trauma center. 

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Level III trauma centers provide 24-hour immediate access to emergency medicine physicians and prompt availability of general surgeons and anesthesiologists. Transfers patients in need of comprehensive care to a Level I or Level II trauma center.

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Level IV trauma centers provide advanced trauma life support (ATLS) to stabilize injured patients before transfer to a higher-level trauma center.  

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Level V trauma centers provide initial injury evaluation, diagnosis and stabilization, then transfers patients to higher level trauma care.

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Trauma Surgery