ER vs trauma center levels

A trauma center is an area of a hospital that’s equipped to treat the most high-risk of injuries — think gunshot wounds, serious car crash injuries, and major burns.

If you experience physical trauma, you’ll receive treatment through a hospital’s emergency department — but not all emergency departments are created equal. In addition to providing emergency care, some hospitals also function as trauma centers, and they’re staffed by specially trained health professionals who treat life-threatening injuries.

Trauma centers offer more extensive care than emergency departments, and the difference between a trauma center and emergency room can be life and death. So, it’s important to understand what these facilities offer.

The Difference Between Trauma Centers and Emergency Rooms

Trauma centers are typically located within hospitals, often in the emergency department. Emergency rooms provide care to people suffering injuries ranging from a sprained ankle to a heart attack — and they are staffed with doctors, nurses, and medical experts who handle a variety of conditions.

Trauma centers, on the other hand, are for patients with the most extreme injuries. At trauma centers, you’ll find highly trained clinicians who specialize in treating traumatic injuries, including:

  • Trauma surgeons
  • Neurosurgeons
  • Orthopedic surgeons
  • Cardiac surgeons
  • Radiologists
  • Registered nurses

They staff the center 24/7 and have access to resources such as an operating room, resuscitation area, laboratory, and diagnostic testing equipment. They are always prepared to treat patients.

When should you go to a trauma center?

In the most serious circumstances, paramedics must evaluate a patient’s condition and decide where they go for care.

Trauma centers treat:

  • Gunshot and stab wounds
  • Major burns
  • Traumatic car crash injuries
  • Blunt trauma
  • Brain injuries

Emergency rooms treat:

  • Broken bones
  • Fainting or loss of consciousness
  • Heart attacks
  • Less severe burns
  • Strokes
  • Severe vomiting, stomach pains, and/or diarrhea

Trauma Center Levels

There are five different levels of trauma centers in the United States, but they can vary from state to state, and not every state recognizes all five levels. Pennsylvania only recognizes Levels I through IV, for example.

The American Trauma Society describes the five levels as:

  • Level I: The center provides total care, from prevention through rehabilitation. These also offer a teaching program for medical residents, as well as ongoing research.
  • Level II: The center is similar to a Level I trauma center but doesn’t necessarily offer teaching or research. Both Levels I and II can treat either children or adults.
  • Level III: The center is smaller than Level I and II centers but can provide prompt care to injured patients.
  • Level IV: The center can provide trauma care and life support before patients are transferred to a larger, higher-level trauma center.

How are trauma centers accredited?

All trauma centers must be accredited (officially recognized) by an independent organization. This accreditation varies by state. In Pennsylvania, the Pennsylvania Trauma Systems Foundation has overseen the accreditation of hospitals since 1986.

What Is a Trauma System?

A trauma system includes many different facilities and services that work together to provide a full range of care for those who are severely hurt. For example, a trauma system might include a Level I trauma center, emergency medical services, rehabilitation centers, and prevention organizations. These systems are typically organized by geographic area.

Trauma Care at UPMC

UPMC Mercy and UPMC Presbyterian are both Level I trauma centers, while UPMC Hamot and UPMC Altoona are Level II. UPMC Children’s Hospital of Pittsburgh serves as a Level I pediatric trauma center. Trauma centers at UPMC are equipped to treat the most seriously injured patients, with operating rooms and specially trained doctors and nurses ready at all times.

UPMC has written the book on trauma care — literally.  Andrew Peitzman, M.D., of UPMC published “The Trauma Manual” 1998. The book, currently available in its 4th edition, is the first comprehensive guide to trauma center care. The manual includes sections on the specifics of patient injury and resuscitation, as well as common problems that trauma staff may encounter with a high-risk patient.

Learn more about these services by visiting the UPMC Trauma Care System website.