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.
The best place to start is with the state trauma program manager. In most cases that person works in the state EMS office, but also could work in the office of rural health or in a freestanding program. The National Association of State EMS Officials provides a general phone and website address for state EMS officials. HRSA has prepared a Farm Rescue and EMS: A State by State Directory.
There are two programs specific to this task:
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 Community-Based Needs Assessment: Assisting Communities in Building a Stronger EMS System.
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 the ACS 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.
Centers for Disease Control (CDC) has the most authoritative information on injury deaths and disability through the WISQUARS database. This is an interactive, online database that provides customized injury-related mortality data and nonfatal injury data useful for research and for making informed public health decisions.
Last Reviewed: 10/29/2013