What's the Difference Between Level I and Level II Trauma Centers?

27 January 2025

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When a severe injury occurs, the type of trauma center you’re taken to can make a critical difference. This blog will explore the key differences and similarities between level I and level II trauma centers, shedding light on their unique roles in providing lifesaving care. We'll discuss what it means for a trauma center to be verified by the American College of Surgeons (ACS), a mark of excellence in trauma services, and emphasize how level II trauma centers deliver exceptional, specialized care for patients.

What is a trauma center?

What to know: A trauma center is a specialized hospital equipped to treat severe, life-threatening injuries such as car accidents or gunshot wounds. Thanks to advanced technology and specialty physicians, these centers provide expert care beyond standard emergency departments to improve outcomes for critical cases.

A trauma center is a specialized medical facility equipped to provide comprehensive care for patients with severe and life-threatening injuries.

It offers immediate emergency treatment, surgical interventions and ongoing critical care to stabilize patients and support their recovery.

Trauma centers play an essential role in the health care system by ensuring critically injured patients receive rapid, lifesaving care.

Unlike regular emergency departments, trauma centers treat immediate physical injuries from external forces such as brain trauma, severe burns and crushing injuries.
From critical care at level I and level II centers to stabilization at rural level IV facilities, trauma centers provide timely, specialized care for every patient.

Each state can have its own designations and criteria for trauma center levels. Most states align their standards with those set by the American College of Surgeons (ACS).

The ACS has a verification process to ensure hospitals meet criteria such as staffing requirements, equipment standards, specific protocols and education/research.
As of 2024, the ACS has three levels of trauma center verification – level I, level II and level III.

In Oklahoma, trauma centers are designated from level I to level IV based on their capabilities.

Level I and level II centers offer the highest care with 24/7 access to trauma surgeons, anesthesiologists and specialists like neurosurgeons and orthopedists. The key difference is that level I centers are required to act as teaching facilities for trauma care.
Level III facilities provide 24-hour emergency services with at least a physician and have general surgical services on-call along with additional requirements of X-ray, laboratory services, recovery rooms and intensive care beds.
Level IV centers staff a 24-hour emergency service with at least a "physician extender" such as a licensed physician’s assistant or nurse practitioner with special trauma training – the focus is on rapid stabilization and transfer to definitive care without requiring surgical or diagnostic services.

Differences between level I and level II trauma centers

Key points: Level I and level II centers are quite similar in care and staff, and provide identical clinical care and quality to trauma patients. The main difference is that a level I trauma center includes a research and education component, meaning they serve as a teaching hospital with residents and fellows.

Overall, both level I and level II trauma centers handle severe trauma cases, but level I centers have additional commitments to research and education.

Level I centers are required to conduct ongoing clinical studies, participate in advancing trauma care protocols and serve as teaching hospitals that train medical students, residents and fellows.
While focused on high-quality care, level II centers are not required to conduct research or engage in education at the same level.

Similarities level I and level II trauma centers share

Both level I and level II trauma centers provide comprehensive care for severe injuries, are staffed with skilled medical professionals and operate 24/7 to deliver high-quality, lifesaving treatment.

They are equipped to handle severe and life-threatening injuries, providing advanced medical care to stabilize and treat critical patients.
Each center maintains a team of specialized trauma surgeons, anesthesiologists and other critical care specialists available around the clock for emergency situations.
They offer immediate surgical intervention, with fully equipped operating rooms and staff to manage complex trauma cases.
They share access to advanced imaging and diagnostic equipment, such as CT scans and MRIs, for fast and accurate assessment of injuries.
Both centers include intensive care units (ICUs) tailored for trauma patients, ensuring continuous monitoring and highly specialized care following surgery or treatment.
Each offers some form of rehabilitation services to help patients recover from serious injuries, though the extent may vary.

Key takeaway: Level II trauma centers are fully capable of providing excellent care for a wide range of serious injuries. They are staffed with skilled professionals and equipped to handle many severe cases.

Trauma care at INTEGRIS Health

Why it matters: In January 2025, INTEGRIS Health became a level II trauma center, providing identical clinical care as a level I trauma center.

The trauma service line at INTEGRIS Health Baptist Medical Center (IBMC) includes a Trauma Emergency Department, Trauma ICU and a Trauma Med/Surgery Intermediate Care Unit.

The trauma team at INTEGRIS Health will handle a wide range of trauma cases, including internal organ lacerations, rib fractures, musculoskeletal injuries, traumatic brain injuries, spinal cord injuries and more.

They will also manage surgical care elements and rehabilitation needs.
The trauma service line is supported by attending trauma surgeons and a dedicated team of advanced practitioners to ensure 24/7 quality care.