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I know this is the top-of-the-line, but what qualifies as this "level 1" why are they top notch, any insight?
Level 1 Trauma
- Thread starter Jccripe
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Good list, but very incomplete. Don't have a good link, but both Mempis and Nashville, TN are level I.
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I don't think he was asking for a list of level 1 trauma centers. He was asking what a level 1 trauma center is, or what makes it special.
If anyone is interested in a list of level 1 centers, however, here you go:
http://www.facs.org/trauma/verified.html
http://www.ptsf.org/pahmap_press3.htm Pennsylvania's system
http://www.floridaacs.org/events/events.html Florida's system
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what I was referring to was that facs.org site is in no way complete. Look at the URL, it doesn't look anywhere near some official government link. It looks like an outside group who has compiled a list, and supposedly verified it. As for PA and FL, I'm not going to fact check you guys, I live in TN, and we weren't even listed even though I know we have at least two level I centers.
As far as why you want to be a medical school with one, you see crap you may never again see. For example, here in Memphis, you get to see the sickle cell patient who was riding his bike, hit a bump, and shot himself in some strange area. Talk about a complicated case. Is it unlikely here, no. Is it unlikely anywhere else, yes. Being in training is about seeing the obscure stuff and hard stuff, level I helps with that.
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Loyola is the sole Level 1 in IL? That most definitely is an incomplete list, unless all others are getting their new accreditation now and all at the same time. I can name a few more without even thinking about it--Cook County, Lutheran General, U of Chicago, Mercy I think is trauma 1 also and that's just chicago itself.
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All of those places may be level 1 according to some other criteria. As far as "true" verified Level I trauma centers go - it's just those on the FACS (faculty of the American College of Surgeons) list - which would only be Loyola.
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The hospitals in Illinois are Level 1 trauma centers by the standards set by the Illinois Department of Public Health. These hospitals can be found at the IDPH website. The IDPH is the governing body in Illinois that oversees the designation of trauma centers. These requirements are set forth in the Illinois EMS act. The FACS is technically a private organization that certifies facilities by their own standards.
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Most states have developed a trauma system that defines levels of trauma centers. That's why when a hospital says they are a "Level I" trauma center - you need to verify (if you care) whether that's a state verification or ACS. Lots of hospitals that are not heavy teaching hospitals may be "Level I" by their state system but an ACS (if they maintain ACS certification) Level II. ACS requires a research component to be a Level I. Therefore, some ACS Level II facilities provide the virtually the same care that an ACS Level I does (they may not have every ACS-I subspecialty in house 24/7 if their state system doesn't require it), but the hospital doesn't support the kind of trauma research needed for ACS I.
In the years when I was working with trauma systems before I went to medical school, a lot of hospitals wanted the prestige of ACS Level I. The trend in recent years for many non-university hospitals has been to let the ACS I designation go, because it's horribly expensive.
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to be a level one trauma center you usually have to have a teaching program, residents and or medical students. there are some really good level twos that aren't ones because they don't have a residency. I belive that to be a level one you also have to particiapte in truama research and injury prevention programs.
"Level I
Provides comprehensive trauma care, serves as a regional resource, and provides leadership in education, research, and system planning.
A level I center is required to have immediate availability of trauma surgeons, anesthesiologists, physician specialists, nurses, and resuscitation equipment. American College of Surgeons' volume performance criteria further stipulate that level I centers treat 1200 admissions a year or 240 major trauma patients per year or an average of 35 major trauma patients per surgeon."
http://www.amtrauma.org/tiep/reports/ACSClassification.html
"Level I
Provides comprehensive trauma care, serves as a regional resource, and provides leadership in education, research, and system planning.
A level I center is required to have immediate availability of trauma surgeons, anesthesiologists, physician specialists, nurses, and resuscitation equipment. American College of Surgeons' volume performance criteria further stipulate that level I centers treat 1200 admissions a year or 240 major trauma patients per year or an average of 35 major trauma patients per surgeon."
http://www.amtrauma.org/tiep/reports/ACSClassification.html
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The previous post hits it pretty close. Level of trauma centers is a designation by the American College of Surgeons that is based primairly on the avalibility of staff and speclities 24//7/365.
The easiest way to think of it is that a Level I trauma center can handle anything and everything that is sent to it via the Emergency Department. There will be no pack and ship to a higher care facility.
Nuts and bolts wise, there are 'criteria' that determine the level of a trauma as it rolls to the doors of the local Emergency Department. If its a small town and whatever coming is 'really bad' then the patient will be stabilized and sent to the higher care facility (usually a Level I trauma center). This facility will have a large team at the doors waiting as a patient rolls in.
The team consits of: Trauma Surgery Attending, Anesthiology Attending, Emergency Medincine Attending, all the aboves line of residents and medical students if they are on the service, respiratory techs, several nurses trained in emergency care... also there will be an Operating Room that is avalible with full staff (scrub techs and the such) at any time of the night/day/year, full CT capabilites with radiology to read 24/7, there will be certain specialists avalible withing a given time frame, such as neurosurgeons, vascular surgery, orthopaedics, etc....and some of the sidelines to this is active trauma research as well as a certain volume of patients that met the criteria.
The exact critera to make a trauma 'activated' (i.e. pagers set off on all the above mentioned people to be in the Emergency Department NOW) varies slightly from hospital to hospital... but generally: Motor vehicle crash over 45mph, prolonged vehicle extraction, fall over 8 feet, burns greater than 20%, traumatic amputation... some even include any field intubations, any gun shot wound, knife wound usually to the chest or abdoman.
Level II and III vary in that they do not have as much avalible as the above. I think Level II is the typical 'large' place without residents as most surgical attendings are at home overnight and instead of requiring to be at the patient in 10 mins or less they have like an hour. Also, a Level I trauma center may get a trauma that they rank a Level II which would mean not as many of the above would need to come to the Emergency Department. Criteria is similar to above but just a little less... maybe burns to 10-20%, fall from 4 feet, MVC reported with an unstable patient, blunt injury to abd but patient stable, etc...
Hopefully my ramblings made sense and shed some light to your question. I think the first time you see an 'activated trauma' will be a memorable experience. I still remember my very first and was simply amazed at everyone doing their part as a team. I am not very happy to be a member of that team....
The easiest way to think of it is that a Level I trauma center can handle anything and everything that is sent to it via the Emergency Department. There will be no pack and ship to a higher care facility.
Nuts and bolts wise, there are 'criteria' that determine the level of a trauma as it rolls to the doors of the local Emergency Department. If its a small town and whatever coming is 'really bad' then the patient will be stabilized and sent to the higher care facility (usually a Level I trauma center). This facility will have a large team at the doors waiting as a patient rolls in.
The team consits of: Trauma Surgery Attending, Anesthiology Attending, Emergency Medincine Attending, all the aboves line of residents and medical students if they are on the service, respiratory techs, several nurses trained in emergency care... also there will be an Operating Room that is avalible with full staff (scrub techs and the such) at any time of the night/day/year, full CT capabilites with radiology to read 24/7, there will be certain specialists avalible withing a given time frame, such as neurosurgeons, vascular surgery, orthopaedics, etc....and some of the sidelines to this is active trauma research as well as a certain volume of patients that met the criteria.
The exact critera to make a trauma 'activated' (i.e. pagers set off on all the above mentioned people to be in the Emergency Department NOW) varies slightly from hospital to hospital... but generally: Motor vehicle crash over 45mph, prolonged vehicle extraction, fall over 8 feet, burns greater than 20%, traumatic amputation... some even include any field intubations, any gun shot wound, knife wound usually to the chest or abdoman.
Level II and III vary in that they do not have as much avalible as the above. I think Level II is the typical 'large' place without residents as most surgical attendings are at home overnight and instead of requiring to be at the patient in 10 mins or less they have like an hour. Also, a Level I trauma center may get a trauma that they rank a Level II which would mean not as many of the above would need to come to the Emergency Department. Criteria is similar to above but just a little less... maybe burns to 10-20%, fall from 4 feet, MVC reported with an unstable patient, blunt injury to abd but patient stable, etc...
Hopefully my ramblings made sense and shed some light to your question. I think the first time you see an 'activated trauma' will be a memorable experience. I still remember my very first and was simply amazed at everyone doing their part as a team. I am not very happy to be a member of that team....
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Wow, the criteria for trauma activation must vary pretty dramatically between hospitals. I found out the hard way last night that our local EMS protocols apparently call for at least a lower-level trauma activation for any MVA where the patient claims any loss of consciousness, regardless of length or severity of accident. (We have two levels of trauma activation...basically the higher one requires more higher ranking people in trauma, anes, and em to come immediately while the lower one is initially handled by residents with support from attendings as needed.) I think our high level trauma activation criteria are similar to the ones you mention.
