Required Components – Level III Trauma Centers must maintain published call

Required Components – Level III 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. It is desirable that a backup surgeon schedule is published. It is desirable that the surgeon on-call is dedicated to the trauma center and not on-call to any other hospital while on trauma call. 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. 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 sooner. 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. The maximum response time for all trauma patients is 60 minutes from the time notified to respond. 4. It is desirable the following specialist be on-call and available 24 hours/day: a. Critical Care Medicine b. Obstetrics/Gynecology Surgery c. Critical Care Medicine d. 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 thoracic surgeon immediately available (within 30 minutes of the time notified to respond). 5. Policies and procedures must exist to notify the transferring hospital of the patient’s condition.