Trauma Centers in Manhattan

[fedor]

How many level 1 trauma centers are in Manhattan?

Where is most of the trauma routed? St Vincents? NYU?

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[mountebank]

I may need some help on this but...

Trauma centers in Manhattan:
St.Lukes
NYU
St.Vincents
Harlem Hospital

other notable trauma centers near Manhattan:
Lincoln
Jacobi
Kings-Downstate

As with any trauma protocol, its distributed to where it occurs. EMS takes a trauma patient to the nearest trauma center, thus Harlem, Lincoln, Jacobi, Kings and often St.Lukes gets the majority of penetrating trauma. All see their fair share of blunt, although not as high as solitary trauma centers like Shock Trauma in Baltimore.

did you ask this question to find out areas to avoid?

 

[fedor]

I may need some help on this but...

Trauma centers in Manhattan:
St.Lukes
NYU
St.Vincents
Harlem Hospital

other notable trauma centers near Manhattan:
Lincoln
Jacobi
Kings-Downstate

As with any trauma protocol, its distributed to where it occurs. EMS takes a trauma patient to the nearest trauma center, thus Harlem, Lincoln, Jacobi, Kings and often St.Lukes gets the majority of penetrating trauma. All see their fair share of blunt, although not as high as solitary trauma centers like Shock Trauma in Baltimore.

did you ask this question to find out areas to avoid?

No, I didn't ask to find out which areas to avoid. I am just a little confused by how trauma is assigned.

Cornell's NY Presbyterian probably has the best funding, and is technically listed as a trauma center, but yet (according to another post) sees very little trauma. Is this because trauma is assigned according to location and little trauma occurs on the Upper East Side and Midtown?

So trauma is assigned purely based on location as long as there isn't a divert. What if the patient will need, for example, an ENT consult and the local ED doesn't have one on call that night. Can the EMT choose to send the patient to another facility which will have an EMT even though it isn't the closest facility?

More broadly, just how much discretion do EMT have in deciding where to send a patient?

 

[fedor]

Can anyone chime in? It doesn't have to be specific about the NYC area. I'm more interested in how trauma patients are in general assigned to hospitals.

 

[jazz]

Can anyone chime in? It doesn't have to be specific about the NYC area. I'm more interested in how trauma patients are in general assigned to hospitals.

trauma goes to the nearest trauma center (granted that one is close by and the patient is relatively stable). in nyc and all urban areas, there are multiple level one trauma centers and thus trauma pt's tend to go to the nearest level one trauma center. in order to be a level one trauma center you have to have all services available (trauma surgery, surgery specialties (neuro, ct, vascular, omfs, ent), optho, radiology (interventional radiology), etc, etc) at all times.

ems has little to no say. they are supposed to bring trauma pts to the nearest trauma center. now, if you are in the boonies, and the nearest trauma center is 30 minute drive away and you have an unstable trauma pt, they could go to the local er, get stabilized (ie chest tube, lines, intubation, etc) and then get sent over to a trauma center. but you won't run into level one trauma centers not having, ent, for instance.

so yes, although there are multiple level one trauma centers in manhattan, given that crime in general (shootings, stabbings) have decreased, you would see less penetrating trauma in manhattan than certain areas of the bronx and brooklyn (downstate comes to mind).

 

[ER-ER-Oh]

It all depends on where the trauma occurred, where the nearest level I trauma center is, and where the nearest emergency dept. is. If the trauma is immediately life threatening it may be up to EMS to decide to go to a level II center if it's just down the block. There the patient might be stabilized and immediately transferred to the level I. I've seen this happen quite a few times in Brooklyn. Also, if EMS feels the trauma is not immediately life threatening they may take a GSW to a lower level ED because they might not have to wait around doing paperwork as long if they know the level I is busy that night. It's usually not the ED, as the other poster notes, that's not level I, it's the hospital in general. Any ED should be able to handle the immediate treatment of any trauma (that's the ideal at least). It's the part about going directly to surgery that makes it a level I. It's the surgeons that will make it seem that it's only them that can make a level I really work. Personally, they just get in my way most of the time, Ha-ha.

 

[mfleur]

Do those of you doing residency in NYC, specifically Manhattan, feel like you get enough trauma exposure? Do any of the programs do a dedicated trauma rotation elsewhere? I don't need quite as much as my home program (LAC-USC) but I do kind of miss the occasional penetrating trauma. Any insight would be greatly appreciated.

 

[totalbodypain]

Do those of you doing residency in NYC, specifically Manhattan, feel like you get enough trauma exposure? Do any of the programs do a dedicated trauma rotation elsewhere? I don't need quite as much as my home program (LAC-USC) but I do kind of miss the occasional penetrating trauma. Any insight would be greatly appreciated.

I am at lincoln in the south bronx and would argue I probably see way more than is necessary. Not in Manhattan but only two stops from it on the 2. Coming from USC you would probably feel at home. We have had attendings from there in the past and they seemed to get along just fine.

 

[EM Junkie]

I learned something new today-

Apparently Memorial-Hermann Hospital in Houston is the nation's busiest Level 1 trauma center in terms of patient acuity/APACHE scores. I knew we had a lot of trauma, but that is a LOT!

FWIW: There are only 2 Level 1's in Houston (Hermann and Ben Taub), but Ben Taub does not have a helipad.

 

[roja]

Do those of you doing residency in NYC, specifically Manhattan, feel like you get enough trauma exposure? Do any of the programs do a dedicated trauma rotation elsewhere? I don't need quite as much as my home program (LAC-USC) but I do kind of miss the occasional penetrating trauma. Any insight would be greatly appreciated.

Not really sure what you are looking for (possible attending position?/nice away rotation?)

I am from SLR. We are a level one in manhattan. We do see plenty of stab wounds, GSW's, blunt trauma, jumpers, etc. Not the volumes that you hear the old timers talk about but we see enough to keep things exciting.

Lots of medical stuff as well.

Our program does a dedicated trauma elective wherever we want (most of us go to miami now) because we wanted one. Overall trauma in NYC/Bronx is down considerably from what it used to be but you still see enough. Harlem still gets a good chunk too from what I hear from my surgical friends there.

Columbia is not a level one trauma center. Its a level on Peds ER.

Feel free to PM me if you have specific questions