How Do Trauma Centers Differ From Emergency Departments? Part I
It’s a common question, “What do you do for a living?”
To which I reply, “I’m a trauma surgeon.” And I’m proud to work with a dedicated and hard-working team at the Washington University and Barnes-Jewish Hospital Trauma Center.
To give you some background, I am a Washington University physician and have been the director of trauma at Barnes-Jewish for almost 6 years and have been at the hospital for close to 10. I completed my residency at Henry Ford Hospital in Detroit and a fellowship in critical care at the University of Michigan. For as long as I can remember, I was always going to become a doctor.
After I state that I work at a trauma center, I get a pretty standard follow up question, “So you work in the emergency room?”
It’s a common misconception, because both places both an emergency room and trauma center are dedicated to providing the best care possible when you or your loved one need it most. But there are some differences between a trauma center and an emergency department.
In general, the emergency department (ED) is where all emergency patients start in the hospital. They may come for something as small as a laceration or a broken finger, or sometimes it’s a more serious condition like heart failure or an asthma attack. In addition, more minor things often appear in an ED, as some people don’t have access to primary care and utilize the emergency room when their condition worsens.
It’s major traumas that make a difference between EDs and trauma centers. Trauma centers are designed to take care of sickest patients. Common traumas include falls, car accidents and serious wounds, such as a gunshot.
Trauma centers come in 4 levels. Level I is the designation given to hospitals able to handle the highest level of traumas and IV is the designation for hospitals able to handle only minor emergencies and refer to other hospitals for additional treatment.
Barnes-Jewish Hospital’s trauma center is verified as a Level I, the highest level of trauma care available, by The Committee on Trauma of the American College of Surgeons. It’s the busiest trauma center in the state, treating more than 12,000 patients last year, and one of only four in the state of Missouri to earn this national distinction. In addition, the Trauma Center is designated as a Level I in Missouri and Illinois.
Trauma centers need to have trauma surgeons, neurosurgeons, facial surgeons, spine surgeons, critical care surgeons and many other specialties on staff and immediately available 24 hours a day, 7 days a week. They must also have the highest quality available in imaging such as Computed Tomography (CT) scans, Magnetic Resonance Imaging (MRI) and interventional radiology. Many EDs have these capabilities, but not 24×7.
In addition, operating rooms are always available, and access to intensive care units (ICUs) is required. A radiology suite, interventional radiology and rehabilitation services are also necessary for the complete care of the trauma patient. Each of these areas are staffed by in-house physicians at the highest level trauma centers as well.
In part 2 of this post, I will discuss how patient care differs.

Category: Trauma


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