Fulton County Hospital in Salem Arkansas earns Level 4 trauma designation

Hi Forum,

I hope that folks explore the levels of designation in the earlier posts. Congratulations to Fulton for their achievement. This will improve local care. From what I can gather, it is important to understand that this Level 4 determination is still largely about stabilization and transfer or "evac." We still need a local treatment 24/7 ER in Sharp if not a full-service hospital. We should not interpret the upgrade at Fulton as meeting the full needs of the community. It is mostly about stabilization and transfer.

Hi Mike & trout,

Here's something along the level of a definition of what the levels of trauma care mean:

Question 4: What do the different levels of trauma centers mean?
Answer: A trauma center is designated a specific level (I, II, III or IV) depending on the available resources to care for patients (specialty physicians, hospital staff and equipment) as well as its ability to participate in trauma research, healthcare professional education and injury prevention. For example, a Level I trauma center is usually a large, urban teaching hospital that can care for all types of injuries as well as provide support to community hospitals, perform trauma research and provide medical education. A Level II facility can care for the majority of trauma patients but may have to transfer some patients with more complex injuries to a Level I center. Level III and IV centers stabilize patients and transport them to a higher level of care if necessary.

That definition is from Georgia.

Wikipedia gives the following definitions:

Note: A trauma center is a hospital that is designated by a state or local authority or is verified by the American College of Surgeons.[9]

[edit]Level I
A Level I trauma center provides the highest level of surgical care to trauma patients. Being treated at a Level I Trauma Center increases a seriously injured patient’s chances of survival by an estimated 20 to 25 percent.[10] It has a full range of specialists and equipment available 24 hours a day[11] and admits a minimum required annual volume of severely injured patients. A Level I trauma center is required to have a certain number of surgeons, emergency physicians and anesthesiologists on duty 24 hours a day at the hospital, an education program, preventive and outreach programs. Key elements include 24-hour in-house coverage by general surgeons and prompt availability of care in varying specialties—such as orthopedic surgery, neurosurgery, plastic surgery (plastic surgeons often take calls for hand and facial injuries, fixing both the bone and soft tissue of these specialized regions), anesthesiology, emergency medicine, radiology, internal medicine, oral and maxillofacial surgery, and critical care—which are needed to adequately respond and care for various forms of trauma that a patient may suffer. Additionally, a Level I center has a program of research, is a leader in trauma education and injury prevention, and is a referral resource for communities in nearby regions.[12]

[edit]Level II
A Level II trauma center works in collaboration with a Level I center. It provides comprehensive trauma care and supplements the clinical expertise of a Level I institution. It provides 24-hour availability of all essential specialties, personnel, and equipment. Minimum volume requirements may depend on local conditions. These institutions are not required to have an ongoing program of research or a surgical residency program.

[edit]Level III
A Level III trauma center does not have the full availability of specialists, but does have resources for emergency resuscitation, surgery, and intensive care of most trauma patients. A Level III center has transfer agreements with Level I or Level II trauma centers that provide back-up resources for the care of exceptionally severe injuries, Example: Rural or Community hospitals.[12]
[edit]Level IV

A Level IV trauma center exists in some states where the resources do not exist for a Level III trauma center. It provides initial evaluation, stabilization, diagnostic capabilities, and transfer to a higher level of care. It may also provide surgery and critical-care services, as defined in the scope of services for trauma care. A trauma-trained nurse is immediately available, and physicians are available upon the patient's arrival to the Emergency Department. Transfer agreements exist with other trauma centers of higher levels, for use when conditions warrant a transfer.[12][13]

[edit]Level V
Provides initial evaluation, stabilization, diagnostic capabilities, and transfer to a higher level of care. May provide surgical and critical-care services, as defined in the service's scope of trauma-care services. A trauma-trained nurse is immediately available, and physicians are available upon patient arrival in the Emergency Department. If not open 24 hours daily, the facility must have an after-hours trauma-response protocol.


The Arkansas Medical Association and Arkansas Hospital Association were on a campaign to get trauma legislation passed in AR. It appears that it has happened now. In any case, here is an interesting article from the Arkansas Medical News in 2009:

http://www.arkansasmedicalnews.com/trauma-system-needed-stat-cms-720

That would probably be the key to a population growth for the area. But it is all about the money.

Yes, Mike. And not just a 24/7 ER but a high-tech one. That's the issue. Scope of care. Better yet, the full hospital. I can't begin to tell you what that would do for employment, property values, and quality of life in the area.

I agree with everything you said. Still need a 24hr ER nearby to CV and asap.

Hi Mike,

No question this is good news provided it doesn't encourage abandoning the bigger project. I would like more details on just what this certification means and what it has actually changed in the services they can provide. Pending more details, congratulations to them.

Fulton County Hospital in Salem Arkansas earns Level 4 trauma designation

This can't hurt. Interesting news.

"The Fulton County Hospital is the only hospital in the state to
receive its trauma designation without one deficiency (being noted
during a survey)," said Board Chairman Al Roork. "This says a lot about
our people. It is a long and difficult process, with a lot of red tape,
to become certified."

http://www.areawidenews.com/story/1730435.html