Required Components: Level II Trauma Centers must maintain published call

Required Components: Level II 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. The trauma surgeon on-call must be unencumbered and immediately available to respond to the trauma patient. The general surgeon is expected to be in the emergency department upon arrival of the seriously injured patient. Hospital policy must be established to define conditions requiring the trauma surgeon’s presence with the clear requirement on the part of the hospital and surgeon that the surgeon will participate in the early care of the 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. The on-call surgeon must be dedicated to the trauma center and not on-call at any other hospital. 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 30 minutes and starts at patient arrival or EMS notification, whichever is shorter. Response time for Bravo Activations is 45 minutes from the time notified to respond. 3. Orthopedic Surgery. It is desirable to have the orthopedists dedicated to the trauma center solely while on-call or a backup schedule should be available. The maximum response time for all trauma patients is 60 minutes from the time notified to respond. 4. Neurologic Surgery. It is desirable to have the neurosurgeon dedicated to the trauma center solely while on-call or a backup schedule should 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 be on-call and available 24 hours/day: a. Critical Care Medicine b. Obstetrics/Gynecologic Surgery c. Plastic Surgery d. Radiology e. 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 should have a board-certified thoracic surgeon immediately available (within 30 minutes of the time notified to respond). 6. Recognizing that early rehabilitation is imperative for the trauma patient, a physical medicine and rehabilitation specialist must be available for the trauma program. 7. Policies and procedures should exist to notify the transferring hospital of the patient’s condition.