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Survey of Critical
Care Services in Trauma Centers
Level I and II trauma centers were surveyed to determine what resources
are available to care for the critically injured trauma patient, how
critical care services are delivered to these patients, and precisely
who is providing these services. Trauma directors and/or trauma nurse
coordinators were asked to provide information pertaining to the
intensive care unit in their center caring for the majority of trauma
patients. These are some of the highlights of the survey. Once available,
the entire survey will be made available on this website through a
link to the published manuscript.
Who was surveyed?
- 452 level I or II trauma centers were surveyed
- 65% (295 responded)
- 73% (139 of 190) of the level I centers responded
- 53% (156 of 262) of the level II centers responded
- With the exception of Alabama, Arkansas, Hawaii and Vermont, all states and
regions of the country are represented.
ICU Bed Numbers
- The average number of physical ICU beds available in these critical care units
is 19, however 15% of centers report having unstaffed beds because of lack of
nurses.
ICU Patient Mix
- The majority (54%) of the ICUs are mixed units, caring for both surgical
and medical ICU patients.
- In the majority of the intensive care units responding, trauma patients
occupied less than 25% of ICU beds.
ICU Bed Availability
- When asked how often there are insufficient beds to admit trauma
patients, 45% of centers always had beds available; 47% had insufficient
beds 1-4 times per month and 13% had insufficient beds more than 5
times per month.
- When asked how often are there insufficient nurses to admit trauma
patients, 45% of centers always had nurses; 42% had insufficient nurses
1-4 times per month, and 13% had insufficient nurses more than 5 times
per month.
Staff Credentials
- 88% of the ICU directors are board certified in critical care.
Care Models
- The most frequent model of critical care delivery (62% of centers)
was one in which both the trauma surgeon and an intensivist collaborated
in the care of the trauma patient.
- Approximately ½ of units surveyed have daily multidisciplinary
rounds with the participation of nutritionist, pharmacist, and/or
a respiratory therapist.
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