Can someone explain Trauma Levels to me?

[grinnurse, RN]

Hate to sound "dumb" this close to graduation but what do the "Trauma Levels" at the hospital level mean? Do they have certain kind of access or units to handle all kinds of traumas or what?

Thanks for the help.

[suzanne4, RN]

Trauma Levels are actually given out by the state's certification board.

Level I is the highest....you usually hear Level I Trauma Center. They must meet vigorous requirements as to having a lab which is open 24/7 as well as blood bank. Must have trauma surgery as well as anesthesia in house. Have to have neurosurgeon, heart surgeon, etc. on call.........OR must be staffed 24/7, they must have OR rooms that are set aside just for trauma, no other routine cases are placed in those rooms. Anesthesia must be available just for trauma, not doing other scheduled cases....

Level II is the next, then Level III, then Level IV which is almost like a clinic or small community hospital, that doesn't even have an OR that functions in the evening...........

Hope that this helps..................

For trauma it is opposite of what you would here for the different levels of an NICU. Level IV in that regard takes the most serious, babies on ECMO and other invasive procedures, then there is Level III, which for many years was the highest ranking. Level II can take stable kids on vents, etc. More like feeder/growers.

[Jennerizer, ASN, RN]

Hospitals may be certified and designated as meeting criteria for trauma care levels by the American College of Surgeons (ACS). There are four levels of trauma care based on the size of the population served and the range of services provided.

LEVEL I

As verified by the American College of Surgeons' Committee on Trauma, a Level I Trauma Center is a comprehensive regional resource that is a tertiary care facility central to the trauma system. A Level I Trauma Center is capable of providing total care for every aspect of injury - from prevention through rehabilitation.

Key elements of a Level I Trauma Center include 24-hour in-house coverage by general surgeons, and prompt availability of care in specialties such as orthopedic surgery, neurosurgery, anesthesiology, emergency medicine, radiology, internal medicine and critical care. Other capabilities include cardiac, hand, pediatric, microvascular surgery and hemodialysis. The Level I Trauma Center provides leadership in prevention, public education and continuing education of the trauma team members. The Level I Trauma Center is committed to continued improvement through a comprehensive quality assessment program and an organized research effort to help direct new innovations in trauma care.

LEVEL II

As verified by the American College of Surgeons' Committee on Trauma, a Level II Trauma Center is able to initiate definitive care for all injured patients.

Key elements of a Level II Trauma Center include 24-hour immediate coverage by general surgeons, as well as coverage by the specialties of orthopedic surgery, neurosurgery, anesthesiology, emergency medicine, radiology and critical care. Tertiary care needs such as cardiac surgery, hemodialysis and microvascular surgery may be referred to a Level I Trauma Center. The Level II Trauma Center is committed to trauma prevention and to continuing education of the trauma team members. The Level II Trauma Center is dedicated to continued improvement in trauma care through a comprehensive quality assessment program.

LEVEL III

As verified by the American College of Surgeons' Committee on Trauma, a Level III Trauma Center has demonstrated an ability to provide prompt assessment, resuscitation, stabilization of injured patients and emergency operations.

Key elements of a Level III Trauma Center include 24-hour immediate coverage by emergency medicine physicians and the prompt availability of general surgeons and anesthesiologists. The Level III program is dedicated to continued improvement in trauma care through a comprehensive quality assessment program. The Level III Trauma Center has developed transfer agreements for patients requiring more comprehensive care at a Level I or Level II Trauma Center. A Level III Trauma Center is committed to the continued education of the nursing and allied health personnel or the trauma team. It must be involved with prevention and must have an active outreach program for its referring communities. The Level III Trauma Center is also dedicated to improving trauma care through a comprehensive quality assessment program.

LEVEL IV

As verified by the American College of Surgeons' Committee on Trauma, a Level IV Trauma Center has demonstrated an ability to provide advanced trauma life support (ATLS) prior to transfer of patients to a higher level trauma center.

Key elements of a Level IV Trauma Center include basic emergency department facilities to implement ACLS protocols and 24-hour laboratory coverage. Transfer to higher level trauma centers follows the guidelines outlined in formal transfer agreements. The Level IV center is committed to continued improvement of these trauma care activities through a formal quality assessment program. The Level IV center should be involved in prevention, outreach and education within its community.

[grinnurse, RN]

Thanks so much for that information. I have always wondered!!

Your fingers must really be tired. Again, thanks!!

Thanks too Suzanne