Trauma Center 101
A trauma center is a type of hospital with the necessary resources and equipment to treat severely injured patients. The American College of Surgeons Committee on Trauma classifies trauma centers as Level I to Level IV (Level I is the highest level of care).
Trauma centers in the United States are an integral part of the emergency health care delivery system, ensuring that millions of people injured each year receive the necessary and appropriate treatment.
According to the Centers for Disease Control and Prevention (CDC), injuries are the leading cause of death for children and adults ages 1–44. The leading causes of trauma are motor vehicle accidents, falls, and assaults. According to the University of California at San Diego Health Center, a trauma occurs every four seconds, and the total direct and indirect cost of trauma in the United States exceeds $133 billion annually.
In the United States, a hospital can receive trauma center verification by meeting specific criteria established by the American College of Surgeons (ACS) and passing a site review by the Verification Review Committee. Official designation as a trauma center may be determined by state law. The general criteria for trauma center verification includes:
A Level I trauma center provides the highest level of surgical care to trauma patients. It has a full range of specialists (including but not limited to surgeons and anesthesiologists) available 24 hours a day, and other specialists (including but not limited to orthopedic surgeons, neurosurgeons, radiologists, internal medicine doctors, oral and maxillofacial surgeons, and/or plastic surgeons) must be promptly available. A Level I trauma center must also provide educational, preventive, research, and outreach programs.
A Level II trauma center provides comprehensive trauma care and supplements the clinical expertise of a Level I institution. It provides 24-hour availability of all essential specialties, personnel, and equipment. These institutions are not required to have the same programs as a Level I center, and trauma patient volume may fluctuate due to the geographic location of the institution.
A Level III trauma center does not have the complete range of specialists like Level I and II centers, but it does have the necessary resources for emergency resuscitation, surgery, and intensive care needed for most trauma patients.
A Level IV trauma center can provide an initial evaluation, patient stabilization and diagnosis, and then transfer the trauma patient as needed to a higher level of care. A Level IV center may provide limited surgery and critical care services.
The following is a 2009 map of the United States showing trauma center access: