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management and immediately involve emergency trauma surgeons whenever injuries
meet any of the following criteria:
• Are multiple or severe.
• Require support of a full trauma team, based on previously established trauma
triage criteria or scores.
• Would benefit from trauma consultation with an emergency trauma surgeon
Trauma centers should have the following attributes:
• Designated as such by emergency medical and public health authorities within the
region, based on self categorization according to established standards.
• Followed by on-site peer verification by impartial trauma experts.
• Subject to ongoing review of performance and participation in the regional trauma
system.
All trauma centers have key organizational characteristics in common:
• All trauma services should be led by a properly qualified and credentialed
emergency trauma surgeon who has education, expertise, and experience in
trauma care.
• This emergency trauma surgeon, together with a trauma nurse program manager
and trauma registrar, should maintain active programs of continuing education
and performance improvement for all members of the trauma service.
• Trauma care should be provided by properly qualified and credentialed physician
specialists in general or pediatric emergency medicine, general or pediatric
trauma surgery, anesthesiology, radiology, pathology, and the three core surgical
subspecialties (critical care, neurologic surgery, and orthopedic surgery).
• This physician team should work in collaboration with properly qualified and
credentialed nursing personnel.
• Appropriate physical resources should include properly equipped emergency
departments, operating suites, intensive and acute-care units, imaging capabilities,
laboratory facilities, and blood bank.
• The in-house trauma team should be available immediately, 24 hours per day, 7
days per week.
• Appropriate and culturally competent mental health, social work, pastoral care,
injury prevention programs, and ideally, professional education and trauma
research programs should be in place to serve both patients and the community.
Level One Trauma Centers. Level One Trauma Centers offer comprehensive care of
seriously injured patients that includes specialists and services for resuscitation, recovery,
and rehabilitation. They usually are located in full-service general or university hospitals
or, in the case of children, in full-service children’s hospitals in which comprehensive
care of the trauma patient is part of the institutional mission. The key issue is
comprehensive, readily available, and consistent care of injured patients by all needed
specialists and services.
Level Two Trauma Centers. Level Two Trauma Centers provide most specialists and
services that are available in Level One Trauma Centers, but typically they are located in
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