Did You Know? Trauma Centers Have 20+ Surgical and Medical Specialties Continually Available?
- Sarah Spilman
- Mar 30
- 2 min read
Level I and Level II trauma centers verified by the American College of Surgeons (ACS) must meet the standards identified in Resources for the Optimal Care of the Injured Patient, otherwise referred to as "the gray book" (because of the color of its cover). Since the latest standards were released in 2022, Level II trauma centers are now required to have 20 specialties with continuous coverage and Level I trauma centers are required to have 22 specialties.
These specialties are listed below, along with the standard in the gray book and the service call coverage requirement.
Specialty | ACS Standard | Level I TCs | Level II TCs |
Anesthesia | 4.13 | 24/7/365 | 24/7/365 |
Cardiology | 4.26 | 24/7/365 | 24/7/365 |
Cardiothoracic Surgery | 4.21 | 24/7/365 | 24/7/365 |
Craniofacial Expertise (ENT, OMFS, or Plastics) | 4.24 | 24/7/365 | |
Emergency Medicine | 4.8 | 24/7/365 | 24/7/365 |
Gastroenterology | 4.26 | 24/7/365 | 24/7/365 |
Geriatric Provider | 4.5 | PIPS | PIPS |
Hand Surgery | 4.21 | 24/7/365 | 24/7/365 |
Infectious Disease | 4.26 | 24/7/365 | 24/7/365 |
Intensivist / Pediatrics | 4.17, 4.26 | 24/7/365 | 24/7/365 |
Microvascular | 4.23 | 24/7/365 | |
Nephrology | 4.26 | 24/7/365 | 24/7/365 |
Neurosurgery | 4.1 | 24/7/365 | 24/7/365 |
OB/GYN Surgery | 4.21 | 24/7/365 | 24/7/365 |
Ophthalmology | 4.22 | 24/7/365 | 24/7/365 |
Orthopedic Surgery | 4.11 | 24/7/365 | 24/7/365 |
Otolaryngology | 4.21 | 24/7/365 | 24/7/365 |
Physiatry | 4.26 | 7 days/week | 7 days/week |
Physician with Training/Interest in Child Abuse | 4.27 | Pediatric Level I - 24/7/365 | |
Plastic Surgery | 4.21 | 24/7/365 | 24/7/365 |
Psychiatry | 4.26 | 7 days/week | 7 days/week |
Pulmonary Medicine | 4.26 | 24/7/365 | 24/7/365 |
Radiology (including interventional radiology) | 4.14 | 24/7/365 | 24/7/365 |
Trauma Surgery | 4.2 | 24/7/365 | 24/7/365 |
Urology | 4.21 | 24/7/365 | 24/7/365 |
Vascular Surgery | 4.21 | 24/7/365 | 24/7/365 |
It goes without saying that maintaining round-the-clock coverage across all specialties represents a substantial financial commitment for hospitals. It is not uncommon for a specialist to be compensated for taking trauma call yet not encounter a single trauma patient during a shift. In well-managed trauma programs, the trauma team helps reduce the burden on other specialties by assessing and often admitting most patients overnight, then arranging subspecialty consultations early the following morning. However, when injuries are life-threatening, trauma centers are able to save lives because these specialists and subspecialists are immediately available to respond.
