Trauma Center, Table 1 Typical characteristics of trauma care resource levels

Level I:

A tertiary care medical facility central to the regional trauma system

24-h in-house coverage by general surgeons; prompt availability in specialties, such as, orthopedic surgery, neurosurgery, anesthesiology

Provides leadership and total care for every aspect of injury from prevention through rehabilitation

Provides leadership in trauma care education, research, and systems planning

Level II:

Hospital-based emergency facility equipped to provide initial definitive care regardless of injury severity

24-h in-house coverage by general surgeons; coverage by specialties, such as, orthopedic surgery, neurosurgery, anesthesiology

Established mechanisms for transfer to a Level I center for comprehensive care

In the absence of a Level I center in the region, provides leadership in the trauma system

Extensive educational opportunities and research are not typical of Level II centers

Level III:

Provides prompt assessment, resuscitation, emergency operations, and stabilization

General surgeons on staff

Access to, and established transfer arrangements with, Level I and Level II centers

More prevalent in rural settings; unnecessary in urban settings with adequate Level I and Level II resources

Levels IV and V:

Provides advanced life support prior to transfer to a higher-level trauma center

Appropriate in rural settings where patient volumes do not support a higher-level center