What is a Trauma Center? By Dr. Meredith

What's a trauma center? When people discuss the number of trauma centers in the country and the number of children's trauma centers they are referencing the American College of Surgeons' standards for being a trauma center. The American College of Surgeons writes those standards and it also has the ability to, through its verification committee, to verify that any given hospital meets those standards.

It does not designate, it verifies. The difference being it verifies that those resources are available. Only a state or a government body can designate a hospital as a trauma center. It is very common to see the words American College of Surgeons Verified State Designated Trauma Center. There are a lot of very good trauma centers in the country that have not gone to the American College of Surgeons for verification but are designated by their state. In doing so, in general, the state will require the hospitals to demonstrate basically the same requirements as the American College of Surgeons does.

So what is a trauma center? A trauma center is a hospital that has made a tremendous commitment to the care of an injured patient. It's made a tremendous commitment in terms of readiness and terms of expertise. Trauma is a disease which can occur in any part of our population, in any place in our country, at any time of day, on any day of the week.

It is a societal investment in the care of our citizens similar to the fire department or a police department. There are very good studies that analyze the effects of improving trauma care, most notably the NSCOT study, the “National Study on Cost and Outcomes in Trauma,” published by Mackenzie, Jurkovich and Rivara. In the New England Journal of Medicine it shows that the death rate for severe to serious injuries was 25 percent less in patients treated at trauma centers than in patients treated in non-trauma centers.

This is a huge difference. We go to an awful lot of trouble to administer, for instance, chemotherapy to a cancer patient with the hopes of garnering a 2 or 3, maybe a 5 percent increase in survival, or decrease in death rates. A 25 percent reduction in death rate is the sign of a very good treatment.

The marked improvement is made because these verified trauma hospitals have made a commitment to have a certain level of training and expertise amongst well-defined staff members, including surgical, emergency medicine, anesthesia, and other medical specialties. They make a commitment to have certain services immediately available, including diagnostic services like CT scanning. Most importantly, trauma centers have the ability of those surgical specialists and operating rooms and intensive care units to take care of the most seriously injured patients immediately and with a high level of expertise.

This is a huge commitment on the part of these hospitals. It's a huge cost on the part of these hospitals and trauma centers, and the public owes them a debt of gratitude. Many of us are privileged to live in communities and states that make this commitment. For others, there is still much work to be done. 

Of the 5,700 hospitals in the U.S., only 1,200 of those are trauma ready. That means only 20 percent of hospitals are truly equipped to handle a trauma. If we can save many more lives and reduce disabilities by having more trauma centers, then we need to discover how that can be done effectively and efficiently and share those plans with hospitals. We can save more lives, especially the lives of injured children, by improving the care they receive when emergencies happen.

Dr. J. Wayne Meredith, Medical Advisor, Childress Institute for Pediatric Trauma