Just another routine, intra-Emergency Department fibroscopic intubation by the
Trauma Anesthesiologists at Ryder Trauma Center
Trauma Center
Information
NSUCOM EMS
Just another routine, intra-Emergency Department fibroscopic intubation by the
Trauma Anesthesiologists at Ryder Trauma Center
What is a Trauma Center?
A trauma center, as trauma surgeons are fond of saying, is NOT just an emergency room. State designated trauma centers meet specific criteria as set forth by governing agencies. Florida is quite specific in their designation of trauma centers and follows the American College of Surgeon's recommendations for accreditation. The Florida Department of Health has a voluminous document, available on line, that details the mechanisms behind accreditation. You can visit the DOH website or specifics. The NSUCOM EMS club will try to provide its members with a basic, "overview" of trauma center services. The trauma surgeon is the resuscitation team leader. The trauma surgeon is an individual who has completed a general surgical resisdency. Trauma surgeons have additional fellowship training (two more years) in surgical critical care and trauma surgery. Currently, the University of Miami/Jackson Memorial Ryder Trauma Center offers these post graduate surgical fellowships.
Florida trauma centers are currently designated as level
one or two. The state does not currently classify level III trauma centers.
Level III trauma centers are basically 24 hour emergency rooms that have
designated trauma teams, on call professionals, and are capable of transferring
patients to a higher level of care. When injured patients meet trauma alert
criteria, state guidelines stipulate that they should be conveyed via emergency
medical services to level one or level two facilities. The term "closest
appropriate facility" applies to the transport of critically ill patients.
Indeed, pediatric patients may require expert care immediately available at
level one or pediatric referral centers. Florida also approves hospitals
to function as pediatric trauma referral centers. These hospitals are either
Level One facilities or meet the qualifications outlined by the American College
of Surgeon's Committee on Trauma.
Level One Facility Requirements:
In house qualified trauma surgeon
In house qualified radiologist
In house qualified emergency physician
In house qualified anesthesiologist
Trauma medical director (trauma surgeon)
Emergency medicine medical director (MD/DO)
Trauma program manager (RN)
24 hour CT availability
24 hour equipped and staffed operating suite
Backup and equipped surgical suite
Trauma intensive care facilities for adult and pediatric patients
Trained trauma team
-At least 1 trauma surgeon (as team leader)
-At least 1 attending EM physician
-At least 2 trained trauma nurses
Dedicated resuscitation suites (to manage two simultaneously multi-system
injured patients)
24 hour laboratory facilities
Protocol for in house burn care
Rehabilitation facilities
Helicopter landing pad
Pediatric resuscitation facilities, personnel, and intensive care units
Administrative requirements
Research requirements
EMS requirements
*The term, "qualified" pertains to
state guidelines. In some instances, senior emergency medicine residents/fellows
or senior surgical resisdents can substitute for their attending
counterparts.
Level Two Facility Requirements:
Same as above, except requirements for in house and on call physicians vary. Level Two facilities generally meet all Level One criteria but are not required to have neurosurgeons/trauma surgeons in house. Furthermore, Level Two facilities are not mandated to handle pediatric trauma. Emergency rooms must necessarily be capable of managing critically ill and injured pediatric patients, but Level II facilities are generally not designated as pediaric trauma referral centers (PTRCs). Some hospitals, like North Broward Medical Center, are Level II designated and elect to keep a trauma surgeon in house 24 hours/day. The state requires that on call trauma specialists must sign a letter of commitment and arrive promptly once summoned by house staff.
State Approved Trauma Centers, as of 07/02
| FACILITY | REGION | DESIGNATION |
| Broward General Medical Center | Ft. Lauderdale | Level One Adult / PTRC |
| North Broward Medical Center | Pompano Beach | Level Two Adult |
| Memorial Hospital Hollywood | Hollywood | Level One Adult / PTRC |
| Ryder Trauma Center at UM/JM | Miami | Level One Adult / PTRC |
| Miami Children's Hospital | Miami | PTRC |
| Orlando Regional Medical Center | Orlando | Level One Adult / PTRC |
| Tampa General Hospital | Tampa | Level One Adult / PTRC |
| Bayfront Medical Center | St. Petersburg | Level Two Adult and PTRC w/All Children's |
| Shands Jacksonville, UFHSCJ | Jacksonville | Level One Adult / PTRC |
| Lakeland Ragional Medical Center | Lakeland | Level Two Adult |
| Sacred Heart Hospital | Pensacola | Level Two Adult |
| Holmes Regional Medical Center | Melbourne | Level Two Adult |
| Hailifax Medical Center | Daytona Beach | Level Two Adult |
| West Florida Medical Center | NW Florida | Level Two Adult |
| Baptist Hospital | Pensacola | Level Two Adult |
| St. Mary's Hospital | Palm Beach | Level Two Adult / PTRC |
| Lee Memorial Hospital | Central Florida | Level Two Adult |
| Delray Beach Medical Center | Delray Beach | Level Two Adult |
| Shands Hospital at the University of Florida | Gainesville | Level One Adult / PTRC |
TRAUMA SPECIFIC LINKS
SOME VISUAL AIDS
Typical Trauma Resuscitation Bay,
Courtesy of ORMC Trauma Center (note overhead X-ray)
Trauma Operating Suite, Courtesy of UM/JM Ryder Trauma Center
Trauma Intensive Care Unit at UM/JM Ryder Trauma Center (Note the FOUR
pleur-evac drainage systems!)
Another Resuscitation Bay (Note Level
One Pressure Infuser)
