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Trauma Center Levels Explained

What is a trauma center?

A trauma center is a hospital, or facility connected to a hospital, with the necessary medical equipment and resources to provide care for patients with severe injuries. In the United States, trauma centers may be classified into five different levels: Level I – V. All facilities, regardless of their level, play a critical role in the American health care system.

The network of trauma centers in the U.S. ensures that countless Americans who have experienced severe injuries are able to receive proper care quickly, and thus have a much greater chance of a full or partial recovery.

It is common for patients who have experienced a traumatic injury may be transported to a hospital with a trauma center by air ambulance. When it comes to HEMS, emergency helicopters may land on a helipad at the trauma center location, or in the case of a fixed-wing transport the air ambulance will land at an appropriate airport or runway where the patient can be transported by ground to a nearby trauma center.

Emergency room vs trauma center

Emergency rooms specialize in quick, more basic treatment of mild to moderate injuries as well as illnesses. However, they do not usually have the specialized equipment and resources to treat more severe injuries.

According to CDC data, there is roughly 25% reduction in fatalities among severely injured patients who receive care at a Level I trauma center rather than a non-trauma center.

Trauma center levels

Level I

A Trauma Center classified as Level I provides the highest level of surgical care to trauma patients. A level I Trauma Center has a full arsenal of highly-trained specialists and equipment available at all times. These facilities are required to have a certain number of emergency physicians, general surgeons, and anesthesiologists on duty at all times. Professionals in various specialties (neurosurgery, orthopedic surgery, radiology, emergency medicine, etc.) must be available to promptly deliver care. Level I centers must also have an education program, a research program, and preventive and outreach programs.

Level II

Level II Trauma Centers work closely with Level I centers. These facilities provide a wide range of high-level specialist care and act to supplement Level I centers. Generally, the biggest difference between Level I and II Trauma Centers is that Level II centers do not need to have ongoing research and education programs.

Level III

Level II Trauma Centers have the necessary resources to provide emergency resuscitation, surgery, and intensive care for the majority of trauma patients. These centers have agreements with Level I and II centers to transfer patients in exceptionally severe injury cases.

Level IV

In some areas where there are not enough resources for a full Level III trauma center, Level IV trauma centers exist. They can provide initial evaluation, stabilization, and diagnosis of seriously injured patients. Level III centers may have surgery and critical-care services. Like Level III centers, they also handle the transfer of patients to higher-level centers. 

Level V

Level V trauma centers provide initial evaluation, stabilization, diagnostic services, and transfer to higher-level facilities. Trauma nurses are available while the facility is open and physicians are available when patients arrive in the Emergency Department. These facilities may not always be open 24 hours a day.

Adult vs Pediatric Trauma Centers

Trauma Centers can be labelled Adult, Pediatric, or Adult & Pediatric. At the same center, the “Level” may be different for each group (ie: Level II Adult / Level I Pediatric).

The reason for the distinction is that pediatric trauma surgery differs greatly from adult trauma surgery. Therefore, different surgeons, specialists, and equipment need to be on hand to treat each age group.

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