trauma codes

[57crew 1]

just a question, what is the deal with trama levels, i have heard them mentioned a couple of times but i don't really understand them? is there an exepted code for trauma cases, does county control reconize trauma codes, or are them more for hospital use? i heard a level 1 trauma mentioned in the Mt. Kisco accident post so i was just wondering.

[DMA327 12]

I believe that level 1 trauma is the worst, however i am not sure how many there are...maybe 3 levels

[x635 4,066]

I personally think people say it to just sound cool. There are no official defined trauma levels in Westchester, nor any system to determine where to take what patients to as there are in other areas outside Westchester. (Like the "Priority" system through C-Med in Conn)

There are Trauma Center levels. Level 1 is usually your large regional university hospital, like Westchester Med, where the major trauma goes, Level II usually more like a larger community hospital, like Sound Shore where the less severe-moderate trauma can go, and your minor trauma Level III is basically anybody.

Trauma center levels are based on things such as staffing, proximity to a highway, number of patients they can handle atf once, ICU aftercare, ED equipment, specialty care areas, etc. TRUE Trauma centers are accredited by the American Academy Of Surgeons, I beleive. Permission to be a trauma center must be granted by the State of NY.

[mikerabbit 2]

I believe this is used in house. WCMC has a list of criteria to be met for level 1 & 2. It was podted on the doors of the two trauma rooms in the old ER.

Mike

[Guest alsfirefighter]

Trauma levels are given to hospitals in accordance to Department of Health Classification.

Level I-Regional Trauma Center. All aspects of care are staffed 24 hours and you must be affiliated with a medical school. Meaning that's one way to staff it. I believe you must also have hyperbaric capability now.

Level II-Area trauma center. Certain functions must be 24 hours, must be able to get needed specialties to the hospital within I believe 30 mins. (most set a 20 min. standard for themselves) to the hospital.

Level III- Basic level, meaning if something comes in, you do the best that you can with what you have.

As a good clinical Paramedic, and EMT provider at that, you should know what cases can and what cases should not be brought to a level II. If there is one in your area. After Hudson Valley gave up their Level II designation, St. Francis and Sound Shore are the only locals on this side of the Hudson. St. Francis (in Poughkeepsie) is a no brainer it needed being between Valhalla and Albany Med.

[Medic137 6]

Danbury Hospital is also Level II

[57crew 1]

thanks that now makes more sense to me

[WAS967 97]

When you call into WMC with a trauma, be sure to call in and tell them you have a level 1 trauma. The surgeons LOVE when you tell them what level code to run. :twisted:

[x635 4,066]

Both Norwalk and Stamford Hospitals are L-2's as well. In addition to Danbury, some of the afformentioned hospitals here are closer to some Westchester communities than WMC.

[WAS967 97]

And let us not forget the might Jacobi which is much closer to areas like South Yonkers, Mount Vernon, and New Ro.....

[DMA327 12]

Thanks for adding to the info fellas

[STAT213 332]

There are two parts to this. The hospital Levels were well described by alsfirefighter. These refer to what the hospital can or cannot treat, Level One being the hospital that can supposedly handle it all.

In addition, WMC has (well had anyway when I was there) ways to classify the trauma patients coming into their facility. Most trauma centers do this, it allows them to determine who should come to the individual cases. The most serious cases mandate a full response.

The different levels are based on physiologic findings of your patients, and some mechanism based stuff. When I worked for STAT Flight, we called the level of trauma we were bringing in, and this sort of got some of the ER staff used to having someone folks call the level of trauma response. I many times remember having folks bring in a trauma and having them wonder what the heck the ER was asking them.

Like the center levels, there are three levels of trauma, 1,2 and 3. A level one trauma at WMC is really banged up, like intubated, sustained hypotension. Level 2 is a little lower still getting some trauma folks to come, and a level 3 trauma is usually handled just by the ED staff.

Bottom line, don't worry about calling the level of trauma. Describe your patient to the ER; that should be enough to get the message across.

Rob

[WAS967 97]

Rob: needless to say my last post was a bit sarcastic. In real life my calls to the med are usually by HEAR and do just what you say: describe the patient and let them sort out what they want to do. My first experience with the new ER was working a patient struck by a vehicle. I called it in over the HEAR radio and they got the picture well. The response appeared to be Level 2 in nature (the guy wasn't all that bad off, worst would have been a good head trauma). People trickled in as the time passed. We have learned in the past that they do NOT like being told what kind of response (Level 1, 2, 3, etc) to mount, but if the patient is really in need, and you feel a full trauma need should be gathered, then my all means make the call. In the end, the best interests of the patient should prevail.

[Guest alsfirefighter]

WAS I don't think he meant nothing by what he was posting other then to some whom aren't as experienced might try to call in with a trauma code to the med center.

I live by this rule, I give my report and while I sometimes take a ribbing because I may give a bit more detail then they want to hear, it is up to them to (supposedly) be ready when you get to that facility. If they are going to the medical center they are either a trauma patient, or warrant a trauma evaluation, they can call it 1, 2,3, xyz set hut hut for all I care.

[Oswegowind 17]

and isn't st joes in yonkers like a trauma center since it all goes there anyway???

[WAS967 97]

WAS I don't think he meant nothing by what he was posting other then to some whom aren't as experienced might try to call in with a trauma code to the med center.

Oh don't worry, I didn't take it as negative. The additional info in fact definatly could help the person who posted the request know the way things work a little better.....and thats what we're here for. 8) And yeah, each ER is different in what they want to hear over the radio. White Plains likes it short an sweet "Comming in with an MI, see you in two" or some other hospitals who like a full set of vitals and ask you for it if you don't tell them. :wink: But sure, if they don't want to hear a dissertation, they can just walk away from the radio and go about their business.

And no St. Joes is NOT a trauma center. Anything requiring a trauma team response should go to a level 2 or higher, which Joes is not. If Traumas are going to Joes, they shouldn't be unless it's an (imminent) arrest.

[Medic137 6]

While St. Joe's is not a trauma center, they do see a lot of trauma. When I was in Yonkers we would bring the really bad cases (life expectancy less than 10 mins) in there. They weren't afraid to roll up their sleeves and get to work. Unlike some of the local hospitals (Putnam, NWHC) that turn off the lights and lock the doors if they hear "trauma".

[WAS967 97]

Ain't that the truth.

[RWC130 594]

SQUAD 51: "Rampart, This is Squad 51...We have administered Sodium Bicarb"

RAMPART: "Squad 51, Can you send us an EKG"

SQUAD 51: "10-4 Rampart"