Trauma center

A trauma center (or trauma centre) is a hospital equipped and staffed to provide care for patients suffering from major traumatic injuries such as falls, motor vehicle collisions, or gunshot wounds. A trauma center may also refer to an emergency department (also known as a 'casualty department' or 'accident & emergency') without the presence of specialized services to care for victims of major trauma. A trauma center (or trauma centre) is a hospital equipped and staffed to provide care for patients suffering from major traumatic injuries such as falls, motor vehicle collisions, or gunshot wounds. A trauma center may also refer to an emergency department (also known as a 'casualty department' or 'accident & emergency') without the presence of specialized services to care for victims of major trauma. In the United States of America, a hospital can receive trauma center status by meeting specific criteria established by the American College of Surgeons (ACS) and passing a site review by the Verification Review Committee. Official designation as a trauma center is determined by individual state law provisions. Trauma centers vary in their specific capabilities and are identified by 'Level' designation: Level-I (Level-1) being the highest, to Level-III (Level-3) being the lowest (some states have five designated levels, in which case Level-V (Level-5) is the lowest). The highest levels of trauma centers have access to specialist medical and nursing care including emergency medicine, trauma surgery, critical care, neurosurgery, orthopedic surgery, anesthesiology and radiology, as well as a wide variety of highly specialized and sophisticated surgical and diagnostic equipment. Lower levels of trauma centers may only be able to provide initial care and stabilization of a traumatic injury and arrange for transfer of the victim to a higher level of trauma care. The operation of a trauma center is extremely expensive. Some areas—especially rural regions—are under-served by trauma centers because of this expense. As there is no way to schedule the need for emergency services, patient traffic at trauma centers can vary widely. A variety of methods have been developed for dealing with this. A trauma center will often have a helipad for receiving patients that have been airlifted to the hospital. In many cases, persons injured in remote areas and transported to a distant trauma center by helicopter can receive faster and better medical care than if they had been transported by ground ambulance to a closer hospital that does not have a designated trauma center. The trauma level certification can directly affect the patient's outcome and determine if the patient needs to be transferred to a higher level trauma center. Trauma centres grew into existence out of the realisation that traumatic injury is a disease process unto itself requiring specialised and experienced multidisciplinary treatment and specialised resources. The world's first trauma centre, the first hospital to be established specifically to treat injured rather than ill patients, was the Birmingham Accident Hospital, which opened in Birmingham, England in 1941, after a series of studies found that the treatment of injured persons within England was inadequate. By 1947, the hospital had three trauma teams, each including two surgeons and an anaesthetist, and a burns team with three surgeons. The hospital became part of the National Health Service on its formation in July 1948 and closed in 1993.The NHS now has 27 major trauma centres established across England, 2 in Scotland, and one planned in Wales. According to the CDC, injuries are the leading cause of death for American children and adults ages 1–44. The leading causes of trauma are motor vehicle collisions, falls, and assaults with a deadly weapon. In the United States of America, Drs. Robert J. Baker and Robert J. Freeark established the first civilian Shock Trauma Unit at Cook County Hospital in Chicago, IL on March 16, 1966. The concept of a shock trauma center was also developed at the University of Maryland, Baltimore, in the 1950s and 1960s by thoracic surgeon and shock researcher R Adams Cowley, who founded what became the Shock Trauma Center in Baltimore, Maryland, on July 1, 1966. The R Adams Cowley Shock Trauma Center is one of the first shock trauma centers in the world. Cook County Hospital in Chicago trauma center (opened in 1966). Dr. David R. Boyd interned at Cook County Hospital from 1963 to 1964 before being drafted into the Army of the United States of America. Upon his release from the Army, Dr. Boyd became the first shock-trauma fellow at the R Adams Cowley Shock Trauma Center, from 1967 to 1968. Boyd returned to Cook County Hospital, where he would later serve as resident director of the Cook County Trauma Unit. According to the founder of the Trauma Unit at Sunnybrook Health Sciences Centre in Toronto, Ontario, Dr. Marvin Tile, 'the nature of injuries at Sunnybrook has changed over the years. When the trauma center first opened in 1976, about 98 percent of patients suffered from blunt-force trauma caused by accidents and falls. Now, as many as 20 percent of patients arrive with gunshot and knife wounds'.