Trauma levels: what you need to know

Trauma centers provide individuals with significant injuries with immediate, definitive treatment. Some sections of the United States accept three trauma center levels, while others accept five levels.

For the most serious injuries, Level 1 is where trauma is always high and needs a rapid 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 differ in how they decide who needs a higher level of trauma center to attend. According to physiological evidence and the form and mechanism of injury, healthcare professionals would likely judge this.

To learn more about the five levels of trauma centers, as well as pediatric trauma centres, keep reading.

Trauma center levels

Trauma center

The highest level is level 1 in U.S. states that accept five levels of trauma centers. The most comprehensible level of trauma treatment is offered by these centers.

As the level decreases, the centers tend to have fewer resources and facilities. The resources and availability of employees, however, are adequate to provide a minimum level of trauma treatment.

Level 1

A specialist treatment facility is a level 1 trauma center. It offers care, including prevention, recovery, and rehabilitation, for each aspect of an injury.

A level 1 trauma center, according to the American Trauma Society , 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

Trauma centers at level 1 and level 2 are somewhat similar, and both can treat patients with serious injuries. Both centers demand that surgeons be available 24-7 shortly after their arrival at the center to respond to a trauma patient.

One of the key disparities between trauma centers at level 1 and level 2 is that centers at level 2 do not have the testing and publication requirements of a center at level 1.

The American College of Surgeons also states that the head of the intensive care unit ( ICU) must be a surgeon with current board qualification in critical surgical care in level 1 trauma centers.

For level 2 trauma centers, which often do not require constant rotations of trauma surgery for senior residents, this provision is not in place.

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 trauma centers at level 1 and level 2, surgeons, anesthetists, and other staff members do not need to be on-site 24 hours a day. However, if the center calls them, they have to be able to visit the hospital within 30 minutes.

Level 4

In more remote areas, Level 4 trauma centers are typically located. Before moving patients to a higher level trauma center, they have facilities for providing advanced trauma life support (ATLS).

ATLS is a medical provider training program that teaches them how to treat those dealing with acute trauma. It helps trauma centers at level 4 to evaluate, stabilize, and diagnose people injured.

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 center for trauma. Level 5 trauma centers can provide ATLS to evaluate, stabilize, to diagnose individuals with injuries, as with level 4 trauma centers.

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 which specializes in the treatment of children who are injured. It must meet all of an adult center ‘s requirements, but it must also include 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 kids 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.

Summary

Trauma centers are places that treat patients who are critically injured or critically ill.

While a three-tier scale of trauma levels is followed by some states, others consider five different levels of trauma centers.

Trauma centers at levels 1 and 2 typically offer more intensive treatment than the lower levels. The lower level centers, however, are also able to assess and stabilize persons, allowing employees to move them if necessary to higher level centers.

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