#International trauma center levels update#

The 2014 update mandated equivalent clinical resources at level I and II centers so that, theoretically, outcomes would be similar. “Resources for the Optimal Care of the Injured Patient” (resources manual) emphasizes the importance of a systems-based approach mandating escalating clinical resources at higher level trauma centers. Since 1976, the American College of Surgeon Committee on Trauma (ACS-COT) has issued trauma center resource guidelines. However, during the time many of these investigations were being reported, there were differences in clinical requirements at level I versus level II trauma centers. It was hypothesized that level II centers have access to inferior resources. Of significance to our study, previous data show that trauma patients presenting with hemodynamic instability have significantly lower mortality in level I versus level II centers and that this discrepancy is sustained during the first hours of admission. Less prevalent are studies showing improved outcomes or equivalency at level II centers. Superior outcomes are reported at level I centers for the severely injured, traumatic brain injury (TBI) patients, those with other specific injuries, and overall mortality. Previous literature outlines significant outcome differences between level I and level II trauma centers.

#International trauma center levels verification#

This potentially relates to the use of more contemporary data gathered after implementation of updated verification requirements. There is no overall or hourly mortality discrepancy between ACS-verified level I and II centers for patients presenting with hypotension.

Early hourly mortality also did not differ.

Adjusted mortality between level I and II admissions was similar (766 vs. 50.3 years p<0.001) with more co-morbidities (mean Charlson Comorbidity Index: 1.43 vs. Level II admissions (2,333 ) were older (46.8 vs.

385 p=0.015), and more severely injured (mean Injury Severity Score: 19.3 vs. Level I admissions (4,931 (67.9%]) were more likely male (3,389 vs. ResultsĪ total of 7,264 patients met the inclusion criteria, of whom most were males (4,924 ) with blunt trauma (5,924 ) being predominated. Logistic regression was performed to identify adjusted associations with mortality. Utilizing the 2017 Trauma Quality Program Participant Use File (TQP-PUF), we identified adult patients (age >14 years) who presented to an American College of Surgeons (ACS) verified level I or II center with hypotension (systolic blood pressure < 90 mmHg). We hypothesize there is no mortality difference between level I and level II centers applying more contemporary data. Being certified with TII also offers you an opportunity to become connected to a like-minded international community of other mission-focused professionals through a searchable directory.Studies show increased early and overall mortality at level II compared to level I trauma centers in hemodynamically unstable patients.

#International trauma center levels professional#

Earning and maintaining a trauma-informed certification is a declaration of continuous professional development. Our trauma-informed certifications are regularly updated as the knowledge base in the specialized area of trauma treatment continues to expand.Īt TII we believe professional accountability is essential as developments are made within the healing community. We provide a wide array of trauma-informed certifications and upon completion of our certification program, you will have acquired state-of-the-art knowledge and skills you need for effective and ethical trauma treatment. We achieve this by supporting care providers on their path to excellence through rigorous, comprehensive certification programs. At Trauma Institute International (TII) we believe to help people face and recover from a history of adversity, professionals need to be equipped with the best training in the industry and have the highest ethical standards.