Early Acute Mgmt in Adults with SCI: Consortium for Spinal Cord Medicine Clinical Practice Guidelines(2008)

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Certainly it is an extraordinary gift to be provided an extensive
guideline by the specialists on management of any traumatic injury.

That being acknowledged, I am concerned about the information on page
one under "Trauma Centers". It notes that the patient should be
immediately transported to a "Level I trauma center as defined by
American College of Surgeons or by the state statute... consider taking
the patient directly to a Level I center if possible in preference to
passing through a Level II or III center first." 

 

The last time our facility as a Level II was reviewed, we were required
by ACS to meet the same standards for neurosurgical care as a Level I.
Is there another standard for acute care of the patient with spinal cord
injury for a I trauma center as defined" by the ACS which is different
than for the Level II centers? Should all Level IIs be bypassed for a
Level I center by EMS?

 

The guideline defers to the definition of an ACS' Level I, so was this
approved by the ACS Committee on Trauma or was any input sought from the
ACS? Have the ACS COT standards changed? 

 

Only those involved in treating the trauma patient in a level II can
understand the frustration dealing with ignorance that assumes that the
level of care provided for a particular injury is better or worse in a
center because it is a Level I or Level II.

 

Everyone in trauma care does understand that trauma care and especially
neurosurgical coverage for trauma patients is difficult nationwide and
to have a guideline to dictate that only a level I can manage these
cases narrows the already diminishing resources available.  

Thank you



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