Trauma in medicine refers to injuries that have the potential to result in a fatality or a long-term disability. Motor vehicle accident, violent assaults involving guns or knives, serious falls, and other physical injuries are examples of trauma. Care for these injuries is specialized, and while trauma care may be provided at emergency rooms, only certain hospitals and medical facilities are actually designated trauma centers.
Trauma centers have to meet a set of criteria outlined by the American College of Surgeons and by state and local governments. These are facilities that are specially equipped to handle traumatic injuries. They are staffed by specially trained medical professionals. There are different levels of trauma centers and patients may be transferred to higher levels for more specialized trauma care. Patients may also get transferred from non-trauma emergency rooms to certified trauma centers.
What is Trauma Care?
Trauma care is specialized medical care for victims of injuries that are considered physical traumas. These are injuries that could be fatal or that could cause permanent, long-term, or serious disability. Trauma may be caused by an accident, such as a vehicle crash or a fall, or it may be an act of violence such as a gunshot wound. A trauma may occur as a result of a natural disaster, a work accident, an act of terrorism, active service in war, a fire, or just an accident that could occur anywhere. For the purposes of statistics, such injuries are categorized as intentional or unintentional.
The medical care given to someone who suffers a trauma is called trauma care. It often overlaps with emergency care, but trauma care is more specialized. There are physicians and nurses with special training, including neurosurgeons, trauma surgeons, and cardiac surgeons, and all staff are trained in trauma care. A trauma center usually has a helipad so that victims can be brought in quickly by helicopter. Trauma centers are always at the ready and are open 24 hours a day to treat patients. Good quality trauma care plays an important role in preventing deaths and minimizing or preventing disabilities. Trauma care includes prevention, treatment, and rehabilitation.
Designated and Verified Trauma Centers
Trauma centers across the U.S. may be designated, verified, or both. The process of becoming a designated trauma center occurs at the state or local level. A hospital with a trauma center must meet the standards set by the local or state government to be named a designated trauma center. The criteria for this designation vary by area and state.
To be a verified trauma center requires meeting the standards set by the American College of Surgeons (ACS). The criteria are the same across the country, so any verified trauma center, no matter where it is, has met the same standards. The verification process includes an evaluation to determine what the trauma center can offer patients, the quality of the staff, the quality of the care, and how many patients are treated. The process of verification is designed to give trauma centers verified status, but also to help trauma centers improve care.
The trauma center verification process includes five different levels, although there also may be recognized trauma levels that vary by state. The ACS levels have standard criteria that trauma centers must meet to achieve each one.
Trauma Care Level I
A Level I Trauma Center is a regional center that provides comprehensive trauma care. It is prepared to care for all aspects of traumatic injuries, from prevention to emergency treatment, and even rehabilitation. A Level I center must be open 24 hours and have immediate access to specialty surgeons and pediatric physicians and surgeons. They must be able to provide local referrals and lead trauma prevention efforts in the community.
Level I verified trauma centers must also provide ongoing development and education for staff. They have to implement quality control assessments and lead teaching and research projects. They must have substance abuse screening strategies and must meet a certain annual minimum intake and treatment of patients.
Trauma Care Level II
To become a verified Level II Trauma Center requires meeting all of the criteria of Level I but also must have additional specialists. Level II centers have access to cardiac surgeons, microvascular surgeons, and hemodialysis equipment. Patients can be sent from a Level I center to a Level II center for these more specialized types of care.
Trauma Care Level III
At Level III a trauma center meets all the standards of the previous levels. It also has transfer agreements in place to facilitate easier movement of patients in from Level I and Level II centers so that patients can get even more comprehensive care. A Level II center is also prepared to provide backup care for rural hospitals in the event they cannot meet the needs of patients.
Trauma Care Levels IV and V
Level IV and V trauma centers meet all the criteria of levels one through three. These centers also have emergency department facilities and staff with advanced trauma life support and laboratory services available 24 hours a day. These facilities have trauma nurses and physicians on standby, waiting for patients and provide critical care as needed. The main difference between the two levels is the volume of patients treated each year.
Pediatric Trauma Care
Most trauma centers can provide care for patients of all ages, but there are also specialized pediatric trauma centers that specifically care for infants and children, through teenagers. For those that provide care for all ages, there may be different level designations for each. For example a trauma center may be Level II for adult care, but only Level I for pediatric care. The first pediatric trauma centers were designated in the 1970s, but the distinction is important. Caring for children with traumatic injuries requires special training, different from adult care.
Trauma care is vital in health care because it provides both immediate, emergency care and specialized care for patients who are at risk of dying or suffering from permanent disability. Traumas are preventable, but still happen often. If you or a loved one experiences physical trauma, you want the best and most immediate care. The high standards set for trauma centers help to ensure that patients do get the best possible care and that these centers never stop improving.