In the United States, a<unk>  provides the highest<unk>  of surgical care to trauma patients.
A<unk>  is required to have a certain number of surgeons and anesthesiologists on duty 24 hours a day at the hospital, an education program, preventive and outreach programs. Key elements include 24-hour in-house coverage by general surgeons and prompt availability of care in specialties such as orthopedic surgery, neurosurgery, anesthesiology, emergency medicine, radiology, internal medicine, oral and maxillofacial surgery, and critical care.<unk>  hospitals in most states in the U.S. (New York, Pennsylvania and Florida among others are notable exceptions) are designated by the American College of Surgeons (ACS) for a period of three years.  Pennsylvania has its own rankings system, based on the criteria of the Commonwealth's Trauma Foundation.
The ACS does not officially designate hospitals as regional trauma centers, however. Numerous U.S. hospitals that are not listed on the organization's trauma roster nevertheless refer to their emergency or trauma units as<unk> s."   The ACS describes that responsibility as “a geopolitical process by which empowered entities, government or otherwise, are authorized to designate.” The ACS’s self-appointed mission is limited to confirming and reporting on any given hospital’s ability to comply with the ACS standard of care known as Resources for Optimal Care of the Injured Patient.
Lower<unk> s of trauma care are provided by<unk> s<unk>  III trauma centers<unk> s
Level I trauma center
Level III trauma center
Level II trauma center
Minor Injuries Unit
Trauma center
APEX Trial
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