Traumas come in many forms: automobile accidents, burns, falls, serious injury and other unplanned events. What they all have in common, however, is that they need immediate, expert treatment. How do you know where to go? Trauma surgeon Dr. James Vosswinkel shares his perspective on how to make such a critical decision.
With so much different terminology describing the levels of emergency services, how do I know what’s best for me?
First, you have to understand the difference between an emergency room and a trauma center. An emergency room provides treatment for illnesses and injuries when you need urgent or same-day medical attention. However, it may not have the capabilities or the trained staff to deal with major trauma that affects multiple body systems. A trauma center like Stony Brook’s has trauma personnel and surgeons as well as other specialists — for example orthopaedics, neurosurgery, critical care, plastic surgery, cardiology — available 24/7. They also have dedicated operating rooms, the latest technology, immediate access to emergency blood supply, sophisticated imaging and many other lifesaving measures in place. When you have a serious injury, you want to be at a trauma center. If you go to a community hospital emergency room, for example, you may need to be transferred to a trauma center. This wastes valuable time when you could have been getting the right treatment by the right experts. In fact, at Stony Brook, 30 percent of our adult trauma patients and 48 percent of our pediatric patients are transferred from hospitals in the county that don’t have full trauma capabilities.
I know there is more than one trauma center accessible to me. Do I have a choice?
Emergency medical service (EMS) providers are trained to recognize patients who can benefit from trauma center care. Using guidelines developed by the Centers for Disease Control (CDC), the EMS providers match patients with the best hospital for their symptoms/injury. At times, this might mean that a patient is taken past a community hospital and brought directly to a trauma center. Why? Studies show that the risk of death for seriously injured patients is reduced by 25 percent when treated in the highest level trauma center. In New York State, the designation of trauma centers is set by the Department of Health, after the hospital is reviewed by the American College of Surgeons Committee on Trauma. Stony Brook serves as the regional (or highest level) trauma center in Suffolk County.
Are there other criteria to consider?
Another thing to keep in mind: Trauma center outcomes are influenced by its experience and the expertise of its teams. It is also important to consider volumes because in healthcare, high volumes are correlated with quality and better outcomes. Ask: How long has the hospital been delivering trauma services? How experienced are the doctors? These things matter.
Why was Stony Brook chosen as the designated regional trauma center?
For all the reasons stated and more. Stony Brook has been a Trauma Center since 1993, caring for 1,800 patients — including 200 children in a dedicated Pediatric Emergency Department open 24/7 — annually. As a university tertiary care facility, Stony Brook is able to offer the highest level of trauma care possible. The survival rates of our trauma patients are among the best in the state. Analysis of data from all the New York State Trauma Centers show that Stony Brook has the lowest mortality rate for seriously injured patients of all downstate and Long Island hospitals. In addition, we are dedicated to improving trauma processes and outcomes through research, ongoing training of staff, standardization of care, performance improvement initiatives and an approach to trauma based on the idea that injury is a disease — that it can be prevented and/or managed in a way to reduce severity and improve patient outcomes.
TRAUMA DESIGNATIONS BY THE NUMBERS
Although the criteria differ by state, the trauma center ranking system (Level I, II, III, IV or V) refers to the kinds of resources and the standard of care available, as well as the ability to handle a certain volume of severely injured patients. Level I is the highest designation, indicating that the most advanced care is available.
Learn more at trauma.stonybrookmedicine.edu.
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