LEVELS OF Trisha Khanal

Independent Study
Mentorship

TRAUMA Semester 1
Fall 2019
Mrs. Daffern
Some of the information in this PowerPoint
is from outside sources. I did not produce all
the information on my own.
Career: Trauma Nurse
Project Topic: Levels of
Trauma
Mentor: Susannah Meg
Michael
Mentorship Site:
Memorial Hermann
MENTORSHIP SITE- MEMORIAL HERMANN
PEARLAND, TEXAS
ISM
This course is designed for students wishing to mentor an adult professional in a chosen career.
Students leave the high school campus and go to the mentor’s place of business to study with
professionals. This course is ideal for the self-motivated student with a passion for a particular
area of study.
Requirements
• Document a minimum of 3 hours of mentorship each week
(Mentorship Activity Log)
• Complete a Journal Entry each week documenting mentorship
experiences (ISM Journal)
• Complete an ISM Professional Portfolio (online format/Weebly)
showcasing assignments completed during the course and the final
project
• Complete all of the required assignments
 My project topic is to describe the different levels of trauma and
what each represent. The reason behind choosing this topic was
Project topic due to the fact that there are many different level of trauma
present in my mentorship.
KEY POINTS

What is Trauma
What are the levels of Trauma
What Events Fall Under Each level
Common Trauma Injuries
Wounds
WHAT IS TRAUMA?

Any serious or life-threatening body damage caused by physical

impact.
Two types of trauma are blunt force and penetrating trauma
Blunt force is when an object strikes the body often causing
concussion, deep cuts or broken bones.
Penetrating trauma is an injury that occurs when an object
pierces the skin and enters a tissue of the body, creating an
open wound.
Blunt Force Trauma Penetrating Trauma
TRAUMA LEVEL 1

 A Level I trauma center provides the highest level of surgical care to trauma patients. Being treated at a Level 1
trauma center increases a seriously injured patient's chances of survival by an estimated 20 to 25 percent.
 level I Trauma Center has a full arsenal of highly-trained specialists and equipment available at all times. These
facilities are required to have a certain number of emergency physicians, general surgeons, and anesthesiologists
on duty at all times. At a Level I trauma center, a team of physicians, surgeons, nurses, X-ray technicians and other
health professionals is available 24 hours a day.
TRAUMA LEVEL 2
Level II Trauma Centers work closely with Level I centers. These facilities provide a wide range of high-
level specialist care and act to supplement Level I centers. Generally, the biggest difference between Level
I and II Trauma Centers is that Level II centers do not need to have ongoing research and education
programs.

REQUIRED
 24-hour immediate coverage by general surgeons, as well as coverage by the specialties of orthopedic
surgery, neurosurgery, anesthesiology, emergency medicine, radiology and critical care.
 Tertiary care needs such as cardiac surgery, hemodialysis and microvascular surgery may be referred
to a Level I Trauma Center.
 Provides trauma prevention and continuing education programs for staff.
 Incorporates a comprehensive quality assessment program
Level 1 Trauma Team Activation Criteria Level 2 Trauma Team Activation Criteria

 SBP<90 at any time in adults  Falls > 20st or pediatric fall> 3 times
 Penetrating wounds to neck, chest or  Ejection from an enclosed vehicle
abdomen  Death of an occupant in same vehicle
 GCS<9 with mechanism attributed to  Anto-ped/bicyclist struck by, thrown or run
trauma over with> 20 mph impact
 Trauma patients receiving blood  2 or more proximal long bone fractures
transfusion (by EMS)
 Intubated patients from the scene
 Trauma patients with severe respiratory
compromise or abstraction
 ED MD Discretion
TRAUMA LEVEL 3
 A level III trauma center does not require an in-hospital general/trauma surgeon 24-hours a day but a surgeon
must be on-call and able to come into the hospital within 30 minutes of being called. Anesthesia and OR staff are
also not required to be in the hospital 24-hours a day but must also be available within 30 minutes. Level III
centers must have transfer arrangements so that trauma patients requiring services not available at the hospital
can be transferred to a level II or III trauma center. Patients with fall-related injuries and fractures are generally a
large percentage of the trauma population cared for at level III trauma centers.
Elements of Level III Trauma Centers Include:
-24-hour immediate coverage by emergency medicine physicians and the prompt availability of general surgeons and
anesthesiologists.
-Incorporates a comprehensive quality assessment program
-Has developed transfer agreements for patients requiring more comprehensive care at a Level I or Level II Trauma
Center.
-Provides back-up care for rural and community hospitals.
-Offers continued education of the nursing and allied health personnel or the trauma team.
-Involved with prevention efforts and must have an active outreach program for its referring communities.
TRAUMA LEVEL 4 & 5

 In some areas where there are not enough resources for a full Level III trauma center, Level IV and V trauma
centers exist. They can provide initial evaluation, stabilization, and diagnosis of seriously injured patients. Level III
centers may have surgery and critical-care services. Like Level III centers, they also handle the transfer of patients
to higher-level centers.
 An avulsion is a partial or complete tearing away of skin
and the tissue beneath. Avulsions usually occur during
LEVEL 1 WOUND violent accidents, such as body-crushing accidents,
explosions, and gunshots. They bleed heavily and rapidly.
Avulsion
 LEVEL 1 WOUND
Gunshot Wound
Physical trauma caused by a bullet from a firearm. Damage may
include bleeding, broken bones, organ damage, infection of the
wound, or loss of the ability to move part of the body.
A gunshot wound (GSW) to the chest may cause damage to
your heart, lungs, esophagus, ribs, or major blood vessels.
How is a severe GSW treated?

~ Medicines may be given to treat pain and prevent infection

A blood transfusion may be given if you have lost blood from your GSW.
~ IV fluids may be given to prevent dehydration and increase blood flow to
major organs.
~A chest tube is a suction device to remove air, blood, or fluid from around
your lungs or heart. A chest tube will help you breathe more easily
~Surgery may be needed to repair damage to organs or blood vessels. It may
also be needed to clean your GSW or remove the bullet.
LEVEL 2 & 3 WOUND
Third degree burn
A third-degree burn is the most serious
kind of burn. It involves all layers of skin
and may damage muscle and other
tissues under the skin. It is so deep that
only the edges heal. Scars will eventually
cover the burned area if skin grafting is
not done.
Third-degree burns destroy the epidermis
and dermis. They may go into the innermost
layer of skin, the subcutaneous tissue. The
burn site may look white or blackened and
charred.
ARTIFACTS
 CURRENT EVENT
Summary
Alcohol related crashes are one of the main reason for death in the United States, killing about
10,000 people per year. Even with all the warnings and educational programs, people still manage to
get behind the wheel while being intoxicated. Drinking alcohol, no matter how much it can not
only affect how quickly you’re able to respond to a different situation but also affects your motor
skills such as eyes, hand and foot coordination. Without being able to do these things, you don’t
just put yourself in danger but also innocent people.

Project Topic Connection

For my mentorship, I am working in a trauma center where I am exposed to major traumatic injuries
such as falls, motor vehicle collision or gunshot wounds. Out of all these injuries, they are presented
with vehicle collision the most
WEEBLY ONLINE PORTFOLIO https://trishakhanal.weebly.com/
CONCLUSION

Studying in this unit allowed me to be exposed to different type

of injuries and wounds. It has helped me feel comfortable in
hospitals and with patients. Next semester I will be shadowing a
NICU or an ER nurse and mentoring in a trauma unit has
prepared me to be successful on the different units.
Thank you to my mentor for giving me this
opportunity to learn about this unit.
Thank you to Mrs. Daffern for being an
amazing teacher. It has been an honor to be
your student,
Thank you to Mrs. B and Mrs. Lynch for
allowing me to share my experience with
you.
 Work Cited
Trauma Center Levels Explained - American Trauma Society, https://www.amtrauma.org/page/traumalevels.

“Trauma Center Levels Explained.” Air Medical Net, 10 Oct. 2012, http://airmedical.net/resource/trauma-center-levels-
explained/.

“What Is The Difference Between A Level 1, Level 2, And Level 3 Trauma Center?” The Hospital Medical Director, 9 Dec.
2018, https://hospitalmedicaldirector.com/what-is-the-difference-between-a-level-1-level-2-and-level-3-trauma-center/.

“Trauma Center Designations and Levels.” Brain Trauma Foundation, https://braintrauma.org/news/article/trauma-

center-designations.

Trauma & Emergency Medicine. “What Is a Trauma Center?: Trauma System Levels: ER or Trauma?” UPMC HealthBeat,
29 Aug. 2018, https://share.upmc.com/2016/05/what-is-a-trauma-center/.