Required Components: Level I Trauma Centers must maintain published call

Required Components: Level I Trauma Centers must maintain published call schedules and have the following physician coverage immediately available 24 hours/day: 1. Emergency Medicine (In-house 24 hours/day). Emergency Physician and/or mid- level provider (physician assistant/nurse practitioner) must be in the specified trauma resuscitation area upon patient arrival. 2. Trauma/General Surgery (In-house 24/hours). The trauma surgeon on-call must be unencumbered and immediately available to respond to the trauma patient. The 24-hour-in-house availability of the attending surgeon is the most direct method for providing this involvement. A PGY 4 or 5 resident may be approved to begin the resuscitation while awaiting the arrival of the attending surgeon but cannot be considered a replacement for the attending surgeon in the ED. The general surgeon is expected to be in the emergency department upon arrival of the seriously injured patient. The trauma surgeon’s participation in major therapeutic decisions, presence in the emergency department for major resuscitation and presence at operative procedures is mandatory. There must be a back-up surgeon schedule published. A system must be developed to assure notification of the on- call surgeon and compliance with these criteria and their appropriateness must be documented and monitored by the PI process. Response time for Alpha Activations is 15 minutes and starts at patient arrival or EMS notification, whichever is shorter. Response time for Bravo Activations is 20 minutes from the time notified to respond. 3. Orthopedic Surgery. It is required to have the orthopedists dedicated to the trauma center solely while on-call. The maximum response time for all trauma patients is 60 minutes from the time notified to respond. 4. Neurologic Surgery. It is required to have the neurosurgeon dedicated to the trauma center solely while on-call or a backup schedule must be available. The maximum response time for all trauma patients is 30 minutes from the time notified to respond. 5. It is desirable the following specialists are promptly available 24 hours/day: a. Cardiac Surgery* b. Cardiology c. Critical Care Medicine d. Hand Surgery e. Infectious Disease f. Micro-vascular Surgery g. Nephrology h. Nutritional Support i. Obstetrics/Gynecologic Surgery j. Ophthalmic Surgery k. Oral/Maxillofacial l. Pediatrics m. Plastic Surgery n. Pulmonary Medicine o. Radiology p. Thoracic Surgery* *A trauma surgeon is presumed to be qualified and have privileges to provide emergency thoracic surgical care to patients with thoracic injuries. If this is not the case, the facility must have a board certified cardiac/thoracic surgeon immediately available (within 30 minutes of the time notified to respond). 6. Policies and procedures must exist to notify the transferring hospital of the patient’s condition.