Different levels of trauma centers
There are five different levels for trauma centers, according to the Centers for Disease Control and Prevention. The designation requires the following:
• A trauma program medical director and a trauma nurse coordinator
• A basic emergency department (minimum)
• Specified service capabilities
Trauma center levels
Level 1 (highest)
A Level 1 trauma center provides the highest level of surgical care to trauma patients. Being treated at a Level 1 trauma center increases a seriously injured patient’s chances of survival by an estimated 20 to 25 percent. It has a full range of specialists and equipment available 24 hours a day and admits a minimum required annual volume of severely injured patients. A Level 1 trauma center is required to have a certain number of surgeons, emergency physicians and anesthesiologists on duty 24 hours a day at the hospital, an education program, and preventive and outreach programs.
Level 2
A Level 2 trauma center works in collaboration with a Level 1 center. It provides comprehensive trauma care and supplements the clinical expertise of a Level 1 institution. It provides 24-hour availability of all essential specialties, personnel and equipment.
Level 3
A Level 3 trauma center does not have the full availability of specialists, but does have resources for emergency resuscitation, surgery and intensive care of most trauma patients.
Level 4
A Level 4 trauma center exists in some states where the resources do not exist for a Level 3 trauma center. It provides initial evaluation, stabilization, diagnostic capabilities, and transfer to a higher level of care. It may also provide surgery and critical-care services, as defined in the scope of services for trauma care. A trauma-trained nurse is immediately available, and physicians are available upon the patient’s arrival to the emergency department.
Level 5
Provides initial evaluation, stabilization, diagnostic capabilities, and transfer to a higher level of care. May provide surgical and critical-care services, as defined in the service’s scope of trauma-care services. A trauma-trained nurse is immediately available, and physicians are available upon patient arrival in the emergency department.
Pediatric trauma centers
A facility can be designated an adult trauma center, a pediatric trauma center, or an adult & pediatric trauma center. If a hospital provides trauma care to both adult and pediatric patients, the level designation may not be the same for each group. This is because pediatric trauma surgery is a specialty unto itself. Adult trauma surgeons are not generally specialized in providing surgical trauma care to children.
Ken de la Bastide
When it comes to trauma centers for treating seriously injured or ill patients, Illinois is among the leaders in the nation.
While Indiana has just nine trauma centers located in Indianapolis, Fort Wayne, South Bend and Evansville, Illinois has 58 trauma centers at the two highest levels spread out across the state.
Joe Albanese, director of Trauma Centers for Illinois, said Illinois started designation of trauma centers in 1971, the first in the country.
“Currently we designate trauma centers at Level 1 and 2,” he said. “We are considering expansion of the designation to other levels.”
Albanese said Illinois uses the American College of Surgeons resource book to designate the level of care provided at each trauma center.
Like Indiana, Illinois has 11 Emergency Medical Service regions.
“There is a trauma center in each region,” Albanese said. “Right now we don’t have a trauma center south of Interstate 72, from Springfield to Quincy. But we have agreements with four trauma centers in Missouri and two in Evansville.”
Albanese said Illinois’ goal is to have one Level 1 trauma center in each region. He said each region decides whether to open new centers based on need.
“It’s a voluntary program,” he said. “Any hospital can apply but a new trauma center has to receive a recommendation from a committee in the region. The region determines if there is a need, not the state. We’re a home-grown designation.”
Albanese said in the case of a Level 1 trauma, the Illinois system bypasses the local hospital, and the goal is to get the patient to the right facility in 25 minutes.
Unlike other states, Illinois provides funding for the operation of trauma centers.
A portion of any moving traffic violation is directed to a state trauma fund.
At the end of each fiscal year, Albanese said, the money is distributed to each of the 11 regions based on the number of fines issued there.
“The money stays in the region,” he said. “Data is collected from each trauma center and the funding is based on the number of trauma patients and the length of stay. The intent was that the majority of trauma injuries are a result of vehicle crashes. It helps fund those facilities that deal with the most trauma victims.”
Illinois has been providing funding to trauma centers since 2003 and, in 2005, a total of $4.9 million was distributed.
Albanese said for hospitals that don’t have the ability to treat trauma patients, the designation is expensive. He said much of the cost comes from specialized equipment and needed physicians.
“All the pieces have to be put together,” he said. “Another factor is the number of patients being treated.
“Overall, our model is to get the right patient to the right hospital the first time,” Albanese said. “We don’t want to transport patients more than once to get them to the right treatment.”
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