Trauma
centers provide immediate definitive care to people with severe injuries. Some
parts of the United States acknowledge three levels of trauma centers, while
others acknowledge five levels.
Level 1 is for the
most serious injuries, where trauma is often large and requires a fast response
time. The lower levels focus on evaluating and stabilizing the person so that,
if necessary, staff can transfer them to a higher level facility.
Hospitals vary in
how they determine who needs to attend a higher level of trauma center.
Healthcare professionals will likely judge this according to physiological data
and the type and mechanism of injury.
Keep reading to
learn more about the five levels of trauma centers, as well as pediatric trauma
centers.
Trauma center levels
In U.S. states
that acknowledge five levels of trauma centers, the highest level is level 1.
These centers provide the most comprehensible level of trauma care.
As the level
decreases, the centers tend to have fewer resources and facilities. However,
the resources and availability of staff are enough to provide a basic level of
trauma care.
Level 1
A level 1 trauma
center is a specialist care facility. It provides care for each aspect of an
injury, including prevention, treatment, and rehabilitation.
According to the American
Trauma Society, a level 1 trauma center usually:
-
has surgeons available within the
facility 24 hours a day
-
has prompt availability of practitioners
such as orthopedic surgeons and neurosurgeons
-
acts as a referral resource for people
in nearby regions
-
provides public education to the
surrounding communities
-
offers continuing education for staff
within its facility
-
uses a quality assessment program
-
uses teaching and research to help
develop and improve trauma care
-
has a screening and intervention program
in place for people living with substance use disorders
-
meets a minimum requirement regarding
the annual volume of severely injured patients
Level 2
Level 1 and level
2 trauma centers are very similar, and both can manage people with severe
injuries. Both centers require surgeons to be available 24-7 to respond to a
trauma patient shortly after their arrival at the center.
One of the main
differences between level 1 and level 2 trauma centers is that level 2 centers
do not have the research and publication expectations of a level 1 center.
The American
College of Surgeons also note that in level 1 trauma centers, the director of
the intensive care unit (ICU) must be a surgeon with a current board
certification in surgical critical care.
This requirement
is not in place for level 2 trauma centers, which also do not require
continuous rotations in trauma surgery for senior residents.
Level 3
A recent article in OTA International notes that level 3 trauma centers typically:
-
provide care to injured people within
their capabilities and resources
-
transfer stabilized patients to level 1
or level 2 centers, when necessary
-
are in areas that are farther away from
higher level trauma facilities
-
provide continuous surgical coverage
-
offer programs to medical staff to
improve care
Unlike level 1 and
level 2 trauma centers, surgeons, anesthetists, and other members of staff do
not need to be on-site 24 hours a day. However, they must be able to reach the
hospital within 30 minutes if the center contacts them.
Level 4
Level 4 trauma
centers are usually located in more rural areas. They have resources to provide
advanced trauma life support (ATLS) before transferring patients to a higher
level trauma center.
ATLS is a training
program for medical providers that teaches them how to manage those dealing
with acute trauma. It enables level 4 trauma centers to evaluate, stabilize,
and diagnose injured people.
Elements of level
4 trauma centers include:
-
basic emergency department facilities
-
trauma nurses and physicians available
when the injured person arrives
-
the provision of surgery and critical
care services
-
the ability to transfer patients to
level 1 or level 2 trauma centers if they require more comprehensive care
-
an active outreach program for its
referring communities
Level 5
Level 5 refers to
the most basic type of trauma center. As with level 4 trauma centers, level 5
trauma centers can provide ATLS and evaluate, stabilize, and diagnose people
with injuries.
The features of a
level 5 trauma center usually include:
-
basic emergency department facilities
-
nurses and medical staff available on
patient arrival
-
after-hours protocols if not open 24
hours a day
-
may provide surgery and critical care
services
-
transfers patients needing more comprehensive
care to level 1, 2, or 3 centers
Pediatric trauma centers
A pediatric trauma
center is a facility that specializes in treating injured children. It must
meet all the criteria of an adult center but also have the following:
-
a pediatric surgeon who oversees the
pediatric trauma service
-
surgeons who have credentials for
pediatric trauma care
-
pediatric specialists in several
disciplines, including orthopedics, neurosurgery, and rehabilitation
-
a separate pediatric emergency room and
ICU
-
specialized equipment to resuscitate
children in all patient care areas
-
pediatric-specific quality assurance and
performance improvement
A 2019 study
analyzed injured children who attended either a pediatric trauma center, a
general trauma center, or a nontrauma center. Children who received treatment
in pediatric trauma centers were more likely to survive their injuries than
those who attended the other facilities.
Trauma centers are
facilities that treat severely injured or critically ill individuals.
Although some
states adopt a three-tier scale of trauma levels, others acknowledge five
different levels of trauma centers.
Level 1 and 2
trauma centers usually provide more comprehensive care than the lower levels.
However, the lower level centers are still able to evaluate and stabilize
people, allowing staff to transfer them to higher level centers if necessary.
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