Anyone have experience in "Level 1" trauma?

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Hi,

I'm writing to ask if anyone has had experience in a level 1 trauma center. I'm curious because I've heard that this type of experience is what NA schools really like. The thing is, as a new graduate I'm wondering about the level of technical/clinical expertise I'll need to be successful in this type of setting. Also, are there "learning/teaching" hospitals that realize the difficulty in adapting to the work? Is it possible to swim, and not sink? What exactly does "level 1" mean?

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Specializes in Nephrology, Cardiology, ER, ICU.

CRNA programs for the most part want ICU experience in level one trauma centers because they treat the most critically injured. Level one trauma centers (at least in IL and this varies from state to state) must have the following:

http://www.facs.org/trauma/faq_answers.html

Here is another article of outcomes for trauma pts dependent on which type of trauma center they are treated at:

http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1402347

Here is a list of level one trauma centers with ER residencies (some of the busiest in the nation):

http://www.aemj.org/cgi/content/abstract/11/5/567-a

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Level I trauma refers to trauma. It is not indicitive of any of the other good programs or units the center may have. Don't be so glued to getting into a level I trauma center.

Case in point....I worked for nearly 3 years in the vascular and trauma surgical ICU at my local urban level 1 university trauma center. Lots of great exposure to trauma, learned lots of cool stuff. Saw a few big vascular cases. Trauma is cool and exciting initally...for the first 24-48 hours...after that it's pretty much rehab and vent weaning to get them to the step down unit. Baby sat a lot of spleens, livers, rib fx's and closed heads too...not really stretching the old gray matter on those. Drip wise...well, unless they're totally trashed, you won't see many drips. Only geriatric traumas with co-morbidities bought a swan.

Nearly 3 years was enough...I needed a change, and wanted to do hearts to round out my experience....a lot more drips, more hemodynamics, IABP's, pacing, etc. Seeing that I was in the only level 1 trauma center in the area it would have made sense to stay there right? Wrong! This particular hospital's heart program is nearly non-existent. They do 1 heart a day...2 max. So, I went down the street to a private hospital with half the number of beds but they do up to 8 open hearts a day...5 days a week...a couple on saturday and sundays are for urgent or emergencies. Given that it's private, I get to do a lot more, and have a ton of autonomy, sometimes more than I like. This hospital has no trauma afiliation. It is however one of the highest volume heart centers in California.

Sorry to be so long winded, but I wanted you to see the differences. Get into a good unit with sick patients. That's the bottom line. Working in a level 1 trauma center is good, if you're in a high acuity unit, such as the surgical trauma ICU. If you work in the CCU where they do 2 caths a day...that won't do you any good.

I hope this helps....

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Specializes in ICU, UT knoxville, CRNA Program, 01/07.

Excellent point, the most important thing in your ICU experience is the EXPERIENCE, not the trauma level designation. Get yourself into a busy fast paced, high acuity ICU CVICU and learn all that you can. bets of luck

Brian

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