J.Jpn. Surg. Soc.. 120(3): 318-323, 2019

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Feature topic

MAJOR TRAUMA CENTERS AND TRAUMA SYSTEMS

Two major trauma centers including our hospital were officially designated in Yokohama. The criteria for a trauma center include: 1) A trauma surgeon must always be present in the hospital and able to arrive in the emergency room (ER) within 5 min from a patient’s arrival. This trauma surgeon is not a general surgeon but an acute-care surgeon who has performed 20 or more trauma operations as the operating surgeon. 2) There must be a trauma call system and a trauma team. The criteria for a trauma call include a patient with a Japan Coma Scale score of ≥10, systolic blood pressure ＜90 mmHg, heart rate ＞120 bpm, or respiratory rate ≥30/min. Under a trauma call, the trauma team consisting of four physicians and three nurses is activated. 3) Emergency surgery must be performed within 30 min after the decision of the team leader. If operating rooms are not available, thoracotomy and laparotomy are performed in the ER. 4) A neurosurgeon or orthopedic surgeon must be present within 30 min after being called by the trauma team leader. In the Yokohama trauma system, all patients with high-energy trauma are transferred to our hospital. An average of 24 trauma patients per month are transported to our trauma center, and one-third are noncritical and can be discharged to their homes after treatment.

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