Trauma Centers: What You Need to Know

If you’ve ever broken a bone or injured yourself to where you need stitches, it can be a traumatizing experience— But, when is an injury severe enough for you to be considered a "trauma patient"?

“To be classified as a trauma patient, you must have suffered significant injuries due to blunt or penetrating trauma, or other physical environmental factors,” says Juan Peschiera MD, a general surgeon and medical director of Trauma Services at Bethesda North Hospital. “If you fall off your bicycle and just break your ankle, you’re not really considered a trauma patient."

What is Trauma?

Legally defined, trauma patients are defined as those who have sustained a significant traumatic injury affecting one or more body systems — a traumatic injury being damage to, or destruction of, tissue that satisfies both of the following conditions:


Poses a significant risk of:

• Loss of life
• Loss of limb
• Permanent disfigurement
• Permanent disability

Is caused by:

• Blunt or penetrating injury
• Exposure to electromagnetic, chemical or radioactive energy
• Drowning, suffocation or strangulation
• A deficit or excess of heat
• Burns

Common Trauma Injuries:

The most common types of trauma injuries the trauma surgeons at Bethesda North Hospital see are as a result of::

• Motor vehicle accidents
• Falls – most common in the elderly population

According to Dr. Peschiera, the spring and summer months are more common for trauma cases due to people being more active outdoors. “People are riding their ATVs and motorcycles, and are traveling more in general, which can lead to more accidents.”

Trauma Centers: When and Where to Go

If you or someone you know is seriously injured, the decision on whether a trauma center or an emergency room is more appropriate will be determined by the paramedics who respond to the incident. “Ohio law requires trauma patients be transferred to the nearest trauma center,” Dr. Peschiera says.

There are five levels of trauma centers, with Level I and Level II having the most comprehensive resources to treat patients from prevention through rehabilitation. It’s a very rigorous process to receive a trauma center verification. This title is awarded by the American College of Surgeons (ACS), Dr. Peschiera says. “If a trauma center isn’t a Level I, it simply means they do not have some of the available ancillary services or subspecialties to treat some types of trauma patients.” 

Dr. Peschiera notes that non-Level I trauma centers must have agreements with Level I centers, allowing patients to be quickly transported once stabilized.

Regardless of the level, all trauma centers must have immediate availability of the following resources on a 24-hours basis to care for severely injured patients:

• Specialized surgeons
• Physician specialists
• Anesthesiologists
• Fully staffed and equipped emergency department with a dedicated trauma resuscitation room
• Nurses
• Resuscitation and life support equipment