Delaware Statewide Trauma System

Delaware’s Statewide Trauma System is comprised of a network of professionals who work together to ensure that trauma patients receive the appropriate emergency medical care for their injuries. The success of the statewide trauma system is the result of much hard work by many people and agencies. The Division of Public Health (DPH) Office of Emergency Medical Services (OEMS) is the lead agency and provides oversight of the system, from injury prevention, access into the system, the full continuum of care, and rehabilitation.

The role of a trauma system is to organize resources and assure their immediate availability to the injured at all times and in all geographic areas of the system. These resources include 911 emergency communications centers, basic and advanced prehospital providers, multidisciplinary trauma teams in hospital emergency departments, in-hospital resources such as operating rooms and intensive care units, and both in-patient and out-patient rehabilitative services.

The number of Delaware residents injured seriously enough to require hospitalization has shown a decline since 2019. We believe that the decline was in part due to people staying home more during the global pandemic. A review of the numbers over the next couple of years should shed some light on this.

As shown below, the mortality rate of all injured patients has dramatically decreased as our trauma system has matured. Comparison is made to national data.

Delaware has an inclusive statewide trauma system, in which every acute care hospital participates in the trauma system and has met the standards for state designation as a trauma center or trauma system participating hospital. Most importantly, this means that no matter where in the state people are injured, they enter a system of care that follows the same guidelines, regulations, and standards and makes sure they are cared for in the facility best able to manage their injuries.

Delaware's Trauma System regulations are based on the guidelines of the American College of Surgeons' Committee on Trauma (ACS COT). ACS review teams visit each Level 1, 2, and 3 trauma center and report to the Division of Public Health on the facility's compliance with the trauma center standards before a hospital can be designated as a Delaware Trauma Center.

Current trauma center and trauma system participating hospital designations are:

REGIONAL LEVEL 1 TRAUMA CENTER:

A Regional Resource Trauma Center has the capability of providing System leadership and comprehensive, definitive care for every aspect of injury from prevention through rehabilitation.

• Christiana Hospital, Christiana Care Health System

PEDIATRIC REGIONAL LEVEL 1 TRAUMA CENTER:

A Pediatric Regional Resource Trauma Center has the capability of providing comprehensive, definitive pediatric trauma care for the most severely injured children within its geographic area. It assumes a leadership role in the care for injured children within its Trauma System.

• Nemours Children’s Hospital, Delaware

COMMUNITY LEVEL 3 TRAUMA CENTERS:

A Community Trauma Center is capable of providing assessment, resuscitation, stabilization, and triage for all trauma patients, arranging for timely transfer of those patients requiring the additional resources of a Regional Trauma or Specialty Center, and delivering definitive care to those whose needs match the resources of this facility.

• Bayhealth Hospital, Kent Campus
• Bayhealth Hospital, Sussex Campus
• Beebe Healthcare
• Christiana Care Health System, Wilmington Hospital
• St. Francis Healthcare
• Tidal Health - Nanticoke Hospital
• Peninsula Regional Medical Center (Salisbury Maryland) via reciprocity

Delaware Trauma

Falls, highway, and assault-related injuries make up over 69 percent of all injury-related hospitalizations in Delaware Trauma System hospitals. Falls have caused the highest number of Intensive Care Unit stays across all age groups.

Trauma in the elderly is a significant health problem. Injuries are a leading cause of hospitalization, long-term care placement, and death in the elderly. As shown in this graph, falls are the number one cause of injury in the elderly by far.

The following graph shows the age distribution of fall injuries seen in Delaware Trauma System hospitals. Despite the high incidence of fall injuries, the mortality rate for seriously injured seniors has decreased in Delaware.

Violent injuries are also a problem in Delaware. The graph below illustrates the breakdown by county on assaults that caused injuries requiring hospitalization, adjusted by population.

The graph below illustrates the types of assaults resulting in death in Delaware in 2021.

This graph provides the age breakdown for hospitalized assault patients.