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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 the 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 problems 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.
This 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. |
