ER Trauma level differences What to gain?

[Gorilla-san]

Currently working as volunteer in Level 3 Trauma ER and I get to see an interesting set of patients but from what I understand hospitals that are a level 1 Trauma centers get a different type of patient all together. Has anyone had experience working in multiple levels of Trauma and what is the difference in terms of the patients seen? Would I gain anything by moving to a Trauma 1 center?

PS: Im not asking this to buff up my application or anything I'm genuinely interested in the experience.

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[Doctor-S]

Currently working as volunteer in Level 3 Trauma ER and I get to see an interesting set of patients but from what I understand hospitals that are a level 1 Trauma centers get a different type of patient all together. Has anyone had experience working in multiple levels of Trauma and what is the difference in terms of the patients seen? Would I gain anything by moving to a Trauma 1 center?

PS: Im not asking this to buff up my application or anything I'm genuinely interested in the experience.

I have staff privileges at a Level I Trauma Center (and among every medical specialty imaginable on this planet, it maintains a full-time neurosurgery department and a regional burn center ... just in case you're super-duper curious).

Level I trauma centers require 15 specific physician specialists be on call and available 24 hours a day, 7 days a week. The center must have either an in-house burn unit or a transfer agreement with a hospital that operates a burn unit. Level I trauma centers are required to provide extensive education and are generally located on the campuses of university teaching hospitals. Level I trauma centers provide multidisciplinary treatment and specialized resources for trauma patients and require trauma research, a surgical residency program and an annual volume of 600 major trauma patients per year.

Level III trauma centers are smaller community hospitals that have services to care for patients with moderate injuries and the ability to stabilize the severe trauma patient in preparation for transport to a higher level trauma center. Level III trauma centers do not require neurosurgical resources.

Simply stated (and as set forth by the American Trauma Society):

Level I

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.

Elements of Level I Trauma Centers 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, plastic surgery, oral and maxillofacial, pediatric and critical care.
• Referral resource for communities in nearby regions.
• Provides leadership in prevention, public education to surrounding communities.
• Provides continuing education of the trauma team members.
• Incorporates a comprehensive quality assessment program.
• Operates an organized teaching and research effort to help direct new innovations in trauma care.
• Program for substance abuse screening and patient intervention.
• Meets minimum requirement for annual volume of severely injured patients.

Level III

A Level III Trauma Center has demonstrated an ability to provide prompt assessment, resuscitation, surgery, intensive care and stabilization of injured patients and emergency operations.

Elements of Level III Trauma Centers Include:

• 24-hour immediate coverage by emergency medicine physicians and the prompt availability of general surgeons and anesthesiologists.
• Incorporates a comprehensive quality assessment program
• Has developed transfer agreements for patients requiring more comprehensive care at a Level I or Level II Trauma Center.
• Provides back-up care for rural and community hospitals.
• Offers continued education of the nursing and allied health personnel or the trauma team.
• Involved with prevention efforts and must have an active outreach program for its referring communities.
  
  Thank you.

 

[frosted2]

Well I was going to reply to this, but I learned a few things myself. Well said @Doctor-S ... thanks!

I do have a quick question though. I was under the impression that a level I trauma center was required to be a burn center. With that being said, do most level I trauma centers just happen to have in-house burn units?

Thanks!

 

[Atom612]

I'm not sure what your duties are currently in your hospital, but I know when I scribed in a hospital with a level I trauma center it was separate from the ED. I was assigned to the emergency physicians in the ED and didn't once step foot in the trauma center. I would make sure you'd be allowed in before switching hospitals.


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[Doctor-S]

Well I was going to reply to this, but I learned a few things myself. Well said @Doctor-S ... thanks!

I do have a quick question though. I was under the impression that a level I trauma center was required to be a burn center. With that being said, do most level I trauma centers just happen to have in-house burn units?

Thanks!

A Level I trauma center must have either an in-house burn unit or a transfer agreement with a hospital that operates a burn unit.

I do not know which (or how many) Level I trauma centers in the USA maintain burn centers. You would have to review each Level I trauma center for this information.

Thank you.

 

[JustAPhD]

Well I was going to reply to this, but I learned a few things myself. Well said @Doctor-S ... thanks!

I do have a quick question though. I was under the impression that a level I trauma center was required to be a burn center. With that being said, do most level I trauma centers just happen to have in-house burn units?

Thanks!

No, they don't need to be a burn center. You can take a look at Lvl 1 trauma centers and compare them to burn centers. You'll find there's more Lvl 1 trauma centers than burn centers.

 

[RogueUnicorn]

Level 1 centers will have bigger peanut galleries interfering with your work