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What does it mean to have a Level I trauma center?

As part of Trauma Awareness Month, we explore what this designation means and what makes VCU Health’s trauma care team unique for our region.

Trauma team in a surgery. Team members are wearing scrubs and have protective gear on their eyes and mouths. More than 4,500 adults and children are admitted annually to the Level 1 trauma center at VCU Medical Center. (VCU Enterprise Marketing and Communications)

By Sara McCloskey

As the only American College of Surgeons (ACS) Level I trauma center in Central Virginia verified to serve adult, pediatric and burn trauma patients, providers at VCU Medical Center have a unique set of skills to save lives after events resulting in serious injuries.

With more than 4,500 adults and children admitted annually, the most common injuries seen by our trauma care team come from car and motorcycle crashes, falls and violent crimes. More than 650 of those patients have burn injuries that are treated in a special part of our trauma center, the VCU Health Evans-Haynes Burn Center.

Michel Aboutanos, M.D., medical director of VCU Medical Center’s Level I Trauma Center and Trauma System Network, and the director of the VCU Injury and Violence Prevention Program, says there are several reasons why our trauma center is unlike any other in the state.

“We provide a holistic approach to patient care that includes addressing the psychosocial impact of trauma. Our team of experts care for our patients’ and their families’ psychosocial needs, both while in the hospital and beyond,” Aboutanos said. “Additionally, we have a robust team of injury prevention and intervention experts. We not only work to prevent injuries, but through collaborative community engagement we intervene and break the cycles of recidivism. Unlike other trauma centers, our academic mission positions us to provide evidence base education and training to almost 50% of all prehospital providers in the commonwealth.”

But what does it mean to be a Level I trauma center? As part of Trauma Awareness Month, VCU Health News explores what this designation means and what makes VCU Health’s trauma care team unique for our region.

How does a hospital or medical center receive a Level I trauma center designation?

A hospital that wants a designation for its trauma care must request the state for a review. To become a Level I trauma center in Virginia, the center must have an organized response to trauma injuries and provide total comprehensive care for every aspect of injury, from prevention through rehabilitation. This verification is renewed every three years to ensure the site is continuing to meet Level I trauma center criteria. Our last renewals happened in 2021 for ACS and 2022 for the state. VCU is the oldest Level I trauma center in the Commonwealth, providing comprehensive trauma care for more than 50 years.

VCU Medical Center’s Level I trauma center is not only state verified but also nationally verified as a Level I adult and pediatric trauma center by ACS, which is the highest level of verification across the United States and internationally.

In general, what services are unique to Level I trauma centers compared to medical centers with other levels of emergency care?

Level I trauma centers must have nearly every surgical and medical specialty available 24/7 to meet the needs of the most complex injuries a patient may sustain. Many patients seen in our Level I trauma center have multiple serious injuries that require a lot of coordination across three or more surgical specialties to ensure the patient’s survival and the best health outcomes. 

Some surgical specialties that may not be available at non-Level I trauma centers such as specialists in facial trauma, spine injuries, infectious disease, pediatric trauma and surgeries to reattach body parts. Patients can only receive this type of specialized care in Level I trauma centers.

What makes VCU Medical Center’s Level I trauma center unique compared to others in the commonwealth?

With more than 200 years of collective trauma and surgical critical care experience, our trauma center is unlike any other trauma center in the state for several reasons. It’s the only one verified in central Virginia to care for adults, children and patients with burn injuries. Our team members also have extensive training in orthopedic trauma surgery and our neurosurgeons are nationally recognized leaders in traumatic brain injury management.

We are the oldest civilian burn center in the United States, providing burn care for more than 75 years. The center is also the only Level I adult and pediatric burn center in Virginia and has received the highest level of verification from the American Burn Association four times.

Having these robust surgical specialties all in one place allows us to provide patients with highly coordinated, quality care from the moment of arrival in our trauma bays to follow-up appointments after being discharged from the hospital.

How does VCU Health partner with first responders to ensure patients receive the best quality care from the ambulance to the hospital?

VCU partners with our EMS colleagues on a daily basis. Clinical feedback begins at the bedside, in coordination with the EMS Liaison and care teams.

In addition, VCU Health provides EMS initial and continuing education. VCU Health offers monthly Virtual Instructor Lead Training (VILT) classes for EMS professionals to continue their education.

Through the VCU Center for Trauma and Critical Care Education (CTCCE), VCU Health directly impacts the future of EMS care by providing the majority of paramedic education throughout Virginia, both locally at VCU Medical Center and remotely through partnerships with localities and EMS agencies. Our clinicians are also selected annually to present at the Virginia EMS Symposium, as many of them are recognized as national experts.

VCU Health has also been a member of the Trauma Survivors Network (TSN) since 2015 and has developed our own local program since then. How does this effort provide more support to patients and their families?

The national Trauma Survivors Network connects trauma survivors and their families with one another, enabling them to share support and information during the recovery process. The network helps to enhance survivor skills and self-efficacy through a hospital-based peer support program, support groups and PTSD education.

Our goal is to build a community of patient and provider advocates dedicated to improving prevention efforts and trauma outcomes. The local TSN chapter continues to expand and includes a peer support volunteers, an average of 25 to 35 medical student volunteers and partnerships with trauma psychology experts and spiritual care as well as various injury and violence prevention programs. We also refer patients to programs in and around the Richmond area after discharge and keep in touch through monthly newsletters, ongoing support groups and other events.

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