HCA Virginia - December 12, 2018

It may feel as though your potentially broken arm warrants a trip to a trauma center but, typically, the emergency room (ER) will do just fine. What is the difference between the two, though, and how do you know what types of injuries or conditions are treated at each? 

To get the best possible care, it is important to know before you go.

What injuries and illnesses do ERs and trauma centers treat?

In many cases, ERs and trauma centers are both located within a hospital. Typically, a trauma center is part of a larger emergency department. While the ER treats a wider variety of ailments, ranging from non-life threatening injuries to potential heart attacks and strokes, a trauma center is equipped to handle the most serious of conditions such as car accident injuries, gunshot wounds, traumatic brain injuries, stab wounds, serious falls, and blunt trauma.

Trauma Center Levels

In the Commonwealth of Virginia, there are three different levels of trauma centers in the United States, though they may vary from state to state and not all states recognize all levels:


  1. Level I: The center provides total care, from prevention through rehabilitation. These also offer a teaching program for medical residents, as well as ongoing research.
  2. Level II: The center is similar to a Level I trauma center but may not offer teaching or research. Both Levels I and II treat both children or adults.
  3. Level III: The center is smaller than Level I and II centers, but provides prompt care to injured patients.


In other states, there may be a Level IV and Level V designation as well:

  1. Level IV: The center provides trauma care and life support before patients are transferred to a larger, higher-level trauma center.
  2. Level V: The center provides initial evaluation, stabilization and diagnostic capabilities and prepares patients for transfer to higher levels of care.


These levels provide guidelines for designating trauma centers throughout the United States. The  Virginia Department of Health then designates that each facility meets the criteria for their designated level of care.

How do trauma centers optimize patient care?

The goal of the American Trauma Society is to “eliminate needless death and disability from injury.” Trauma centers require a coordinated, multidisciplinary approach to stabilize and care for the patient. A Level I trauma center, for instance, has well-established treatment protocols in place and certain types of healthcare professionals on duty 24 hours a day, 7 days a week. These professionals have advanced training in triage and critical care, including:


  • Surgeons, with specialties in:
    • Orthopedics
    • Cardiothoracics
    • Neurosurgery
    • Vascular surgery
    • Ophthalmic surgery
    • Plastic surgery
  • Emergency physicians
  • Anesthesiologists
  • Radiologists
  • Gerontologists
  • Nurses
  • Respiratory therapists


In addition, many trauma centers include other on-site resources, such as:

 Helipads that allow victims to be airlifted to the hospital for faster treatment

  • 24-hour trauma resuscitation area in the ER
  • Operating rooms
  • Lab testing
  • Diagnostic testing
  • Blood bank
  • Pharmacy

 Emergency Medical Technicians (EMTs), also called paramedics, often decide the level of treatment that the injury or illness necessitates. For people with the most critical conditions, those that threaten the loss of life or limb, being treated at a Level I trauma center can significantly increase their chances of survival and recovery.


Do trauma centers offer any additional services?

Yes, in addition to critical emergency care, trauma centers often have:


  • Coordinated services with Emergency Medical Services (EMS) so that the trauma center stands ready with the necessary healthcare professionals and equipment needed to treat the victim as soon as he or she arrives.
  • Community outreach programs, including trauma prevention.
  • Rehabilitation services for those recovering from a trauma.
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