What does a hospital have to do to become a trauma center?

A hospital will have to apply to the Alabama Department of Public Health (ADPH) to become a trauma center. There will be an inspection by a team of doctors, nurses, and emergency medical technicians (EMTs) from both the trauma region and ADPH to determine the level at which the hospital is capable of participating. There is no cost other than the hospital must provide a dedicated phone line that does not go through the hospital switchboard (to attach the monitoring computer) and enough space in the emergency department (ED) to house the computer and printer. The ATHS will provide the hardware and software and will maintain it.

If my hospital becomes a trauma center, how many trauma patients can I expect to see each month?

This will vary depending on the region and hospital resources.

How will I know if a trauma system patient is being routed to my hospital?

The Alabama Trauma Communications Center (ATCC) will obtain information about the patient from the EMSP on the scene. This information will be sent to the printer attached to the monitoring computer in the emergency department. It will print out a patient report. The computer in the emergency department will also sound an alarm that there is an incoming trauma system patient, and the trauma center will receive a notification call from the ATCC. When the EMS unit is about five minutes from the hospital they will call and give an update on the patient's condition.

Will the surgeon have to meet every ATHS patient when he or she arrives in the emergency department?

Level I trauma centers should have a team meet all patients who are unstable and require resuscitation. Level II trauma centers should have the surgeon called to meet patients who are unstable and require resuscitation. Patients with stable vital signs may be evaluated by the emergency physician and the surgeon consulted when needed.

The surgeons at my hospital also take call at another hospital. How will it affect our trauma status when they are on call at another hospital?

This will be worked out on a case-by-case basis depending on the number of surgeons and the proximity of the hospitals. There are several different options that can be worked out to make it acceptable for both the surgeons and the hospitals.

We only have two surgeons on our staff. They cannot cover trauma every day. How will our being "red" affect us as far as Quality Improvement (QI)?

While we monitor each hospital's time on "red," we also allow for each hospital's staffing situation. In some cases having a hospital "green" only part of the time is far superior to having no trauma center available in the area.

My hospital is concerned about the cost of maintaining the commitment to be a trauma center. Will there be any funds to help?

We recognize that funding will be crucial to maintaining the trauma system. We are confident that we can be successful in approaching the Alabama Legislature to obtain the funds needed to keep this life-saving system going.

What if we commit to being a trauma center but find that we are unable to maintain the commitment?

Participation is voluntary. A hospital can change its level of commitment or may withdraw from the system at any time by giving 30-day written notice. During the 30-day period the hospital may still set itself "red" for any resources that are lacking.

If my hospital is "red," will we ever get a patient?

There are three situations where the EMS provider is to immediately take the patient to the closest hospital (whether they are a trauma center or not):

  • The EMS provider is unable to effectively manage the airway or ventilate the unstable patient.
  • The EMS provider is unable to stop the bleeding of a patient with severe hemorrhage.
  • The EMS provider is unable to establish/maintain an IV to provide volume resuscitation in an unstable hypovolemic patient.

If your hospital was "red" and you were brought a patient that met one of these criteria, the ATCC would arrange transfer to the appropriate hospital as soon as your ED physician (or your surgeon) got the problem under control. The other exception is if the patient demands to be taken to your hospital. In Alabama, the patient always has the last word about where they are to be taken.

If all hospitals are "red," what will happen?

The ATCC will try to match what resources a hospital has available with what it appears the patient will need combined with all transport options. Since 1996, when the trauma system began operation in the BREMSS Region, there has never been a time that any region was all "red." The chance that there would be no hospital available to take a patient is extremely slim.

Will my hospital be allowed to advertise as a trauma center?

No hospital can hold itself out as a trauma center unless it has been designated by ADPH. However, those hospitals that are designated can advertise that they are designated trauma centers.

Who should I contact for additional questions?

You may contact:

  • William E. Crawford, MD
    State EMS Medical Director
    Office of EMS
    Phone: 334-290-3088
  • Alice Floyd, RN, BSN
    Acute Health Systems Manager
    Office of EMS
    Phone: 334-290-3088

Is there an application packet available for review?

Yes, you can download an application packet.

How does Alabama's Trauma and Health System compare with other state's system?

Alabama's system correctly identifies the patients who need trauma care, locates the hospitals with the available resources needed to treat the patients, routes the patient correctly the first time to reduce time to appropriate care, improves care by the QI process, and keeps the hospitals and doctors in control of the process. No other state has a system that can do this.

Page last updated: September 4, 2020