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Frequently Asked Questions
What is a trauma center?
A trauma center is a
specialized hospital that treats victims of physical trauma.
Physical trauma is defined as blunt, penetrating or burn injury
that requires immediate medical treatment in order for the
person who has sustained such injury to survive. Most often,
these types of injury are the result of falls, auto accidents,
gunshots, stabbings and/or burns. A trauma center is staffed 24
hours a day, 7 days a week with a trauma surgery team that is
specially qualified to attend to traumatic injury. After the
patient is stabilized, his/her continuum of care is the
responsibility of the trauma center staff until the patient is
released from the trauma center.
Why are trauma centers
needed? Can't accident victims be treated in our local emergency
rooms?
Emergency rooms are not
established in such a way as to provide the same services within
the same time frame as a licensed trauma center. They function
under lesser requirements than trauma centers. Trauma centers
are required to have a staff of certified trauma surgeons on
staff and present at all times. In addition to these surgeons,
it is also required that a staff of specialists and
sub-specialists be available on an "on-call" basis, responding
within a specifically defined number of minutes. All of these
requirements are in place in order to provide highly specialized
care within one hour of injury (the "golden hour").
What is the difference
between a Level II Trauma Center and other levels of trauma
care?
The State of Florida
Department of Health licenses trauma centers at three levels. A
trauma center can be a level I trauma center, a level II trauma
center and/or a Pediatric trauma center. Florida statute
mandates that level I Trauma Centers must also be pediatric
trauma centers.
Level I trauma
centers require 15 specific physician specialists be on call and
available 24 hours a day, 7 days a week. The center must have
either an in-house burn unit or a transfer agreement with a
hospital that operates a burn unit. Level I trauma
centers are required to provide extensive education and are
generally located on the campuses of university teaching
hospitals.
12 of Florida's 21 trauma
centers carry a level II designation. Level II
centers are required to provide coverage from the same
specialists and sub-specialists as level I centers but the time
requirements and in-house staff requirements are different.
However, all designated physicians are required to respond
on-call within much more stringent time frames than a non-trauma
hospital emergency department. It should be noted that major
differences between level I and level II centers are found in
regard to pediatric specialists being required in level I
centers and requirements of teaching hospital designation
required of level I centers.
Pediatric trauma centers
have the responsibility to meet the same criteria as adult
trauma centers. However, they must have a pediatric emergency
department, pediatric resuscitation equipment in all patient
areas, and a Pediatric Intensive Care Unit (ICU). Pediatric
trauma centers are required to have on staff trauma surgeons
that are credentialed for pediatric care. Pediatric trauma staff
must be trained in the complex problem of treating children,
including infants, and have numerous hours of specialized
pediatric care training. Florida has two pediatric-only trauma
centers.
I have heard that Lee
Memorial Hospital's trauma center has experienced financial
difficulties. With the cost of medical care today, how can there
be a financial shortfall?
Lee Memorial Health System
is the largest publicly-owned entity in Florida that receives no
direct tax support. this includes the LMHS trauma center. While
many of Florida's trauma centers and Trauma Districts are set up
with taxing authority, the LMHS trauma center and the Lee County
Trauma Services District currently have no such taxing ability.
The absence of a steady
funding stream is made worse by the cost of meeting the
stringent requirements that are put in place by the state in
order to assure that licensed trauma centers operate at
appropriately high levels of expertise and service. The stand-by
costs of equipment, space for treatment and highly skilled
personnel create an annual shortfall of between $10 million and
$11 million for the LMHS trauma center.
Through the efforts of LMHS
administration working with the state legislature and
appropriate state agencies, LMHS has been able to offset
approximately half of the shortfall each of the past two years.
However, these funding sources remain unreliable over the long
term. Currently, Lee Memorial Health System continues to absorb
financial losses incurred due to operating the LMHS trauma
center in order to continue to provide this vital service to the
Southwest Florida community. Efforts to identify and implement a
steady and dependable funding source for the LMHS trauma center
are ongoing.
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