Trauma Frequently Asked Questions
Question: Can, and should, my rural hospital be part of the regional and statewide trauma system?
Answer: Yes. Given that death rates for injury are higher in rural and frontier areas it is imperative that all rural acute care facilities that receive emergency patients be part of the trauma system. This allows for a more organized response at the local level and ensures that those patients who need interventions and care above your facility’s capabilities are identified and transferred to a higher level of care in a timely manner. Evidence clearly supports the notion that an inclusive system that involves all facilities results in fewer unnecessary trauma deaths.
Question: Who should I contact about my regional or statewide trauma system?
Answer:
The best place to start is with the state trauma program manager. In most cases that person works in the state EMS office, in others it is in the office of rural health and, in still others it may be a freestanding program. HRSA provides a complete list of state EMS contacts.
Question: Are there training programs to assist my rural medical and ancillary staff become better organized and prepared to receive injured patients?
Answer:
There are two programs specific to this task. One focuses entirely on trauma and is known as the Rural Trauma Team Development Course. It is sponsored by the American College of Surgeons. Information can be found at their website. The second course, the Comprehensive Advanced Life Support or CALS Program covers organization and training for general resuscitation and stabilization techniques for injured patients as well as other life threatening conditions.
Question: How can local EMS agencies be integrated into the local and regional systems of trauma care?
Answer:
The local acute care facilities often play an important role in engaging local EMS agencies in issues surrounding trauma care. Often the EMS agency’s medical director is affiliated with the local facility. This provides a natural bridge between the two agencies on issues of triage protocols, trauma team activation and quality improvement activities. It is, sometimes, helpful to engage in a specific community planning process that sets out to use existing EMS resources more effectively through horizontal integration at the community level. A planning process and associated materials are found in the document titled, “Community-Based Needs Assessment: Assisting Communities in Building a Stronger EMS System."
Question: I have heard references to specific levels of trauma care. Are these levels mandated by the federal or state governments and where can I find information about these levels of care?
Answer:
Currently there are no national standards or federal designations for levels of trauma care. According to the American College of Surgeons (ACS) the designations of trauma care facilities is a geopolitical process by which empowered entities such as state governments are authorized to designate. Often it will be the state EMS office that will determine what those standards are. Some states use the ACS verification process, which is voluntary, to determine the levels of trauma care for their healthcare facilities. Although ACS does not designate trauma centers it will verify the presence of resources that are listed in their document, Resources for Optimal Care of the Injured Patient. This document can be ordered from their website. For additional information on the levels of trauma care see the ACS document: Definitive Care Facilities. ACS also provides on their website a list of trauma centers that have successfully completed a verification visit.
Credits
Thanks for contributions from:
Nels Sanddal at the Critical Illness and Trauma Foundation (CIT), Carol Williams and Sally Garneski at the American College of Surgeons (ACS)
Developed by: Kathy Spencer,
kathy@raconline.org
Last revised 10/09/2007
