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Level I: A level I trauma center provides the most comprehensive trauma care. There must be a trauma/general surgeon in the hospital 24 hours a day. There must also be an anesthesiologist and full OR staff available in the hospital 24-hours a day as well as a critical care physician 24-hours a day. There must also be immediate availability of an orthopedic surgeon, neurosurgeon, radiologist, plastic surgeon, and oral/maxillofacial surgeon. These centers must participate in research and have at least 20 publications per year.
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Level II: There are several minor differences between a level I and II trauma center but the main difference is that the level II trauma center does not have the research and publication requirements of a level I trauma center.
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Level III: does not require an in-hospital general/trauma surgeon 24-hours a day but a surgeon must be on-call and able to come into the hospital within 30 minutes of being called. Anesthesia and OR staff are also not required to be in the hospital 24-hours a day but must also be available within 30 minutes. Patients with fall-related injuries and fractures are generally a large percentage of the trauma population cared for at level III trauma centers.
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Level IV: provides initial evaluation, stabilization, diagnostic capabilities, and transfer to a higher level of care. It may also provide surgery and critical-care services, as defined in the scope of services for trauma care. A trauma-trained nurse is immediately available, and physicians are available upon the patient's arrival in the Emergency Department.
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Level V: provides initial evaluation, stabilization, diagnostic capabilities, and transfer to a higher level of care. They may provide surgical and critical-care services, as defined in the service's scope of trauma care services. A trauma-trained nurse is immediately available, and physicians are available upon patient arrival in the emergency department. If not open 24 hours daily, the facility must have an after-hours trauma response protocol.