![]() "But you can’t just plan for the worse case because the worst case will probably be worse than planned for in many ways." "Like anything else, you shouldn’t plan only for the best case," says Winchell, who is a professor of surgery at Weill Cornell Medicine and the chief of trauma, burns, acute care and critical care. He says the answer involves "some science and some politics" and includes whether policymakers want to spend money to, say, prevent violence or treat it. The American College of Surgeons' trauma system committee has been trying to come up with a formula to determine how many trauma centers areas should have for about a dozen years, says surgeon Robert Winchell, who has heads the college of surgeons' committee. "Locations have more to do with population and need and ability to keep the doors open," he says. Several western states, including Colorado and Oregon, only have one Level 1 center while some don't have any. "This is why mortality is significantly improved in these hospitals, and it is why I would always want to be taken to an ACS verified Level I trauma center if I were severely injured," Stewart said this summer.Īlthough smaller or similarly-sized cities, including Washington, Baltimore and Atlanta, have two or more Level 1 trauma centers, American Trauma Society executive director Ian Weston says there may not be enough business to support the cost of certifying another Level 1 center in Las Vegas or even Nevada. Level 1 trauma centers are the "gold standard" for the treatment and assessment of seriously injured patients, says trauma surgeon Ronny Stewart, who chairs the trauma committee at the American College of Surgeons' (ACS), which regularly verifies centers meet the criteria. The Southern Nevada Health District, in a 2015 report, said the area wanted more "trauma coverage but does not want to be saturated with trauma centers or to have too many trauma centers so as to destabilize the existing centers." The report noted the "the number and location of trauma centers" need to be "periodically" studied. Level 1 trauma centers must have certain personnel, such as trauma specialists within specialties including cardiology and orthopedics, equipment and quality improvement processes. Patients with moderate to severe injuries taken to a Level 1 trauma center have about a 25 to 30% better chance of survival compared to those taken hospitals that are not trauma centers, according to a 2006 study in the New England Journal of Medicine (NEJM), the latest research available. Several hospitals that don't have trauma centers also received patients. Rose Dominican in nearby Henderson, Nev., is a Level 3 trauma center and received 58 patients. The University Medical Center (UMC) of Southern Nevada, which is in Las Vegas, received 104 of the shooting victims, while the city's Sunrise Hospital and Medical Center, which is a Level 2 trauma center, received 180 shooting victims. Nevada's only Level 1 trauma center overflowed with victims of Sunday's shooting rampage that killed 58 people in Las Vegas, which forced neighboring hospitals with fewer resources devoted to trauma care to pick up the slack. Watch Video: Go inside a Las Vegas trauma hospital
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