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Do Trauma Centers Have the Capacity to Respond to Disasters?

Rivara, Frederick P. MD, MPH; Nathens, Avery B. MD, PhD, MPH; Jurkovich, Gregory J. MD; Maier, Ronald V. MD

The Journal of Trauma: Injury, Infection, and Critical Care: October 2006 - Volume 61 - Issue 4 - p 949-953
doi: 10.1097/01.ta.0000219936.72483.6a
Original Articles
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Background: Concern has been raised about the capacity of trauma centers to absorb large numbers of additional patients from mass casualty events. Our objective was to examine the capacity of current centers to handle an increased load from a mass casualty disaster.

Methods: This was a cross-sectional study of Level I and II trauma centers. They were contacted by mail and asked to respond to questions about their surge capacity as of July 4, 2005.

Results: Data were obtained from 133 centers. On July 4, 2005 there were a median of 77 beds available in Level I and 84 in Level II trauma centers. Fifteen percent of the Level I and 12.2% of the Level II centers had a census at 95% capacity or greater. In the first 6 hours, each Level I center would be able to operate on 38 patients, while each Level II center would be able to operate on 22 patients. Based on available data, there are 10 trauma centers available to an average American within 60 minutes. Given the available bed capacity, a total of 812 beds would be available within a 60-minute transport distance in a mass casualty event.

Conclusions: There is capacity to care for the number of serious non-fatally injured patients resulting from the types of mass casualties recently experienced. If there is a further continued shift of uninsured patients to and fiscally driven closure of trauma centers, the surge capacity could be severely compromised.

From the Harborview Injury Prevention and Research Center (F.P.R., A.B.N., G.J.J., R.V.M.), and the Departments of Pediatrics (F.P.R.), Epidemiology (F.P.R.), and Surgery (A.B.N., G.J.J., R.V.M.), University of Washington, Seattle, Washington.

Submitted for publication January 11, 2006.

Accepted for publication March 7, 2006.

Address for reprints: Frederick P. Rivara, Harborview Injury Prevention and Research Center, Box 359960, 325 Ninth Ave, Seattle, WA 98104; email: fpr@u.washington.edu.

© 2006 Lippincott Williams & Wilkins, Inc.