Do You Know the Difference Between Trauma and Emergency Care?

Doctors in trauma for a patient.

Within the Emergency Department at Lancaster General Hospital is Lancaster County’s only accredited Level I Trauma Center. While some people may assume trauma and emergency care are interchangeable, there are specific criteria that must be met in order for a hospital to earn Trauma Center designation. Trauma Centers are then further categorized by level, based on specific capabilities which vary by state. 

What it Means to be a Level I Trauma Center

In Pennsylvania, all Trauma Centers must be accredited by the Pennsylvania Trauma Systems Foundation (PTSF) after a rigorous process and review. Levels range from I to IV (1 to 4), with Level I representing the highest designation that can be earned.

According to the PTSF, accredited Level I Trauma Centers must be continuously prepared to treat the most serious life-threatening and disabling injuries. This requires 24/7 availability of a team of medical providers with specialized training and expertise in  caring for severely injured patients, along with onsite resources and technology needed for this type of care. These include but are not limited to (a):

  • Trauma resuscitation area
  • Dedicated operating room
  • Laboratory testing
  • Diagnostic testing
  • Blood bank
  • Pharmacy

Level I requirements also include trauma research and a surgical residency program. The American Trauma Society describes a Level I Trauma Center as a comprehensive resource in the region that is “capable of providing total care for every aspect of injury—from prevention through rehabilitation.” The inclusion of research and teaching helps trauma center hospitals educate communities about safety and injury prevention, lead new innovations in trauma care, and train the next generation of surgeons. 

Since 1986, Lancaster General Hospital had been serving our community as a Level II Trauma Center. The hospital met all the conditions for becoming a Level I Trauma Center, with the exception of a trauma residency program, which was established in July 2019. The hospital was elevated to Level I in 2020.

Advanced Medicine at the Ready

One of the most important components of a Level I Trauma Center is ‘round-the-clock access to health care providers in a range of advanced specialties such as trauma surgeons, neurosurgeons, orthopaedic surgeons, cardiac surgeons, plastic surgeons, anesthesiologists, radiologists, and nurses. 

Access to specialized expertise is something patients in both the Trauma Center and Emergency Department share. Physicians and other providers from Penn Medicine Lancaster General Health, as well as colleagues in the Penn Medicine system, may be consulted or asked to collaborate on a diagnosis, treatment plan, rehabilitation, or follow-up care. 

Specialists in neurosurgery, orthopaedics, geriatrics, neurology, cardiovascular medicine, orthopaedics, infectious diseases, cancer and more often treat patients as part of a multidisciplinary care team. Additional support may be provided by social workers/case management, therapists, dietitians, pain management experts, financial counselors, and hospital chaplains.

In other words, the Trauma Center and Emergency Department serve as a critical entry point to a full spectrum of advanced medicine, which is why they are so vital to a healthy community. 

Trauma or Emergency Care?

Trauma Centers treat injuries that commonly occur as the result of serious falls, motor vehicle crashes, serious burns, and assaults, such as gunshots or stabbings. These injuries threaten life or limb and require immediate intervention.

Conditions treated in Emergency Departments range from minor injuries to possible heart attacks and strokes. The training for Emergency Medicine differs from Trauma because it typically encompasses a broader spectrum of conditions. These include:

  • Broken bones
  • Chest pains
  • Loss of consciousness
  • Minor burns
  • Minor cuts requiring stitches
  • Severe abdominal pain, vomiting or diarrhea
  • Sprains
  • Several allergic reaction (swelling lips, difficulty breathing or swallowing)
  • Signs of a heart attack
  • Signs of a stroke

When a patient arrives at the Emergency Department, physicians quickly assess (“triage”) the urgency of the condition and determine if the patient should be treated by specialists in Emergency Medicine or by specialists in the Trauma Center. 

Patients who are transported by ambulance are typically taken to the nearest Emergency Department with the capability of stabilizing and/or treating the injury or illness. That determination may begin with a call to 911. 

Lancaster General Hospital recently completed a segment of its multi-year ED expansion and enhancement project.

author name

Eric H. Bradburn, DO, FACS

Eric H. Bradburn, DO, FACS, is a general and trauma surgeon with LG Health Physicians Trauma and Acute Care Surgery and Division Chief of Trauma at Lancaster General Hospital. Dr. Bradburn is a graduate of Lake Erie College of Osteopathic Medicine. He served residencies at Penn State Milton S. Hershey Medical Center and Wellington Regional Medical Center, and a fellowship at the University of Tennessee Health Science Center.

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