Design of the Northern Nevada Orthopaedic Trauma Panel: A Model, Level-II Community-Hospital System
Timothy J. Bray, MD

The level-II trauma center has been defined by the American College of Surgeons as "a hospital capable of delivering definitive trauma care regardless of the severity of injury."1 In geographically isolated areas, the level-II center frequently assumes the responsibilities of the level-I center, including education, systems development, leadership, and research.

Although much has been written about the general surgical aspects of trauma, very few articles in the literature offer the orthopaedic surgeon guidelines for the design, development, implementation, and maintenance of orthopaedic trauma panels in community or level-II trauma systems. In the current article, these specific issues are discussed and questions regarding the daily functions of orthopaedic trauma care in a community system are addressed.

The Reno, Nevada, trauma system is a unique level-II community trauma program that has successfully fulfilled the designation criteria of the American College of Surgeons2. The Northern Nevada Orthopaedic Trauma Panel functions as an integral part of the trauma program and can serve as a model system for other programs in the early developmental phase or for programs having problems maintaining high practice standards. This program has withstood the critical recertification process set forth by the American College of Surgeons' Committee on Trauma.

The Northern Nevada Orthopaedic Trauma Panel was designed in 1994 as a consult service to the Washoe Health System Trauma Program for the management of orthopaedic trauma. The panel is composed of orthopaedic surgeons who are members of several different private group practices in Reno, Nevada. The panel is open to orthopaedic surgeons who are committed to the enhancement of trauma care and are willing to participate in trauma education and hospital trauma-committee activities. The current panel consists of fifteen board-certified orthopaedic surgeons under the direction of a subspecialty-trained orthopaedic traumatologist (Table I). The panel members have signed a …

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