All services and surgical specialties are available 24 hours a day and there are specific differences in the types of trauma and emergencies, as they are called within the hospital with different teams carrying different pagers. The location of Ohio's trauma centres means that most Ohioans live within 25 miles of a Level I, II or III trauma centre hospital. There must also be an anaesthesiologist and full operating room staff available at the hospital 24 hours a day, as well as an intensive care physician 24 hours a day. A level I trauma centre is able to provide total care for all aspects of injuries, from prevention to rehabilitation.
The levels of trauma centres are determined by the type of trauma resources available in the hospital and the number of trauma patients admitted each year. In addition, Level I and II trauma centres must have a spectrum of medical specialists including cardiology, internal medicine, gastroenterology, infectious diseases, pulmonary medicine and nephrology. Level III centres should have transfer agreements so that trauma patients requiring services not available at the hospital can be transferred to a Level II or III trauma centre. A level 2 hospital may have a NICU, but only for stable infants; others would be sent to the tertiary hospital in the region.
A level V trauma centre provides initial assessment, stabilisation and diagnostic capability and prepares patients for transfer to higher levels of care. Level I, II, III, IV or V) refers to the types of resources available at a trauma centre and the number of patients admitted annually. Patients with fall-related injuries and fractures typically make up a large percentage of the trauma population seen at Level III trauma centres. Their large medical centres are often the receiving hospital for problematic patients from other hospitals.
Patients assigned to level 2 were more likely to use cardiac monitoring, electrocardiogram, medication and specialty consultation than patients assigned to level 3.Level II is the emergency department of most large and medium-sized hospitals, with surgeons and anaesthesiologists on call 24 hours a day, with an ICU and usually staffed by specialists in emergency medicine. If, at the end of the triage interaction between the patient and the nurse, the nurse assigned the patient to Level 2 or Level 3, additional clinical data related to that patient were collected in the ED chart. Level III trauma centres do not have such extensive requirements in terms of specialists on staff and only require general surgery, orthopaedic surgery and internal medicine.