Oklahoma’s Lifeline: Why Level I Trauma Centers Matter

Inside OU Health’s Level I Trauma Center: Oklahoma’s only nationally verified Level I Trauma Center

It’s 3 a.m. in Oklahoma. The roads are dark and the city quiet when a call comes in – a multi-vehicle crash on I-35 with multiple critical injuries. Within minutes, trauma surgeons, neurosurgeons and orthopedic specialists assemble in the trauma bay. Blood products are en route, operating rooms are prepped, and the system shifts into high gear.

This is what OU Health’s Level I Trauma Center was built for.

In 2024 alone, 9,000 Oklahomans experienced traumatic injuries severe enough to require care at OU Health. These were patients facing life-threatening conditions after car crashes, violent assaults, workplace accidents, or catastrophic falls. For them, the difference between a Level I Trauma Center and a lower-level facility determined whether they survived.

But what exactly sets a Level I Trauma Center apart? And why is OU Health’s distinction so critical for Oklahoma?

What is a Level I Trauma Center?

Not all trauma centers are created equal. The American College of Surgeons (ACS) designates trauma centers from Level I to Level V, with Level I offering the highest and most comprehensive level of care. OU Health is one of approximately 240 hospitals in the country to have ACS Level I adult trauma center verification. OU Health also has pediatric level I trauma at Oklahoma Children’s Hospital OU Health. Achieving verification signifies that OU Health has voluntarily met 122 standards outlined by the ACS.

To achieve Level I status, a hospital must meet strict criteria, including:

• Serving as a referral resource for communities in nearby regions.
• Leading in prevention and public education efforts for surrounding communities.
• Offering continuing education to trauma team members and incorporating a comprehensive quality assessment program.
• Operating an organized teaching and research effort to direct new innovations in trauma care.
• Screening for substance abuse and intervening with patients as needed.
• Meeting the minimum requirement for annual volume of severely injured patients.
• Ensuring on-call specialists (neurosurgeons, orthopedic trauma surgeons, interventional radiologists, and more) are available within 30 minutes and that door to OR for trauma is 15 minutes or less.
• Keeping dedicated trauma operating rooms ready at all times.
• Managing mass casualty events and large-scale disasters effectively.

For Oklahomans suffering from severe, multi-system trauma such as brain injuries, internal bleeding, or complex fractures, OU Health is the only ACS-verified Level I Trauma Center. It is the only facility with the specialized personnel, resources, and systems to provide a full spectrum of comprehensive trauma care from prevention to rehabilitation.

This status is not easily earned, nor is it easily maintained. Unlike other facilities that may call themselves trauma centers, OU Health undergoes rigorous evaluation and re-verification by the American College of Surgeons every three years. This evaluation scrutinizes everything from response times to patient outcomes, ensuring that the highest standards of care are consistently met. The trauma center has consistently been reverified every three years since 2001.

"Nobody would want to be in a non-stroke center getting stroke care," said OU Health Level I Trauma Center Director Dr. Alisa Cross, M.D., FACS, associate professor in the Department of Surgery at the University of Oklahoma College of Medicine. "That’s what we offer by being ACS-verified. We’ve had to meet the highest quality metrics, and our care is held to the absolute highest standard."

Depth of Bench: Why Trauma Care is Like Football

Dr. Cross often compares OU Health’s trauma care to a football team’s “depth of bench” and explains what makes OU Health's trauma center different.

"It's like having a star quarterback with skilled backups ready to step in if needed," she said. "For the most severe trauma cases—those that require extensive resources—we have both the equipment and the expert personnel to handle the worst of the worst."

This means that no matter how many critically injured patients arrive at once, OU Health’s extensive and highly skilled team enables the center to handle multiple complex cases at once, ensuring patients receive the care they need without delay.

OU Health’s Trauma Team Includes:

• 10 Trauma Surgeons: All double board-certified in general surgery and surgical critical care.
• 4 Fellowship-Trained Orthopedic Trauma Surgeons: Experts in managing complex orthopedic injuries.
• Multiple Neurosurgeons: Available 24/7 to address critical neurological trauma.
• 4 Interventional Radiologists: Specialists in stopping internal bleeding without the need for open surgery.
• Over 70 Specialized Nurses: Rigorously trained in trauma care.
• Dedicated Trauma Anesthesiologists and Facial Trauma Specialists: Ensuring specialized care for all trauma-related needs.
• Full Burn Care Team: Expertise in treating both minor and severe burn injuries.
• 20 Advanced Practice Providers: Physician extenders focused solely on trauma care.
• Additional Specialists: Including 2 orthopedic specialists, 1 geriatric trauma specialist, and 1 rehab medicine specialist.
• In addition, there is a well-rounded multidisciplinary team that prioritizes mobilization, wellness, and efficient and expedient discharge to post-acute care facilities. This team includes trauma social workers, trauma-specific occupational, speech, and physical therapists, and multiple discharge planners.

Dr. Cross emphasized the importance of this coordinated effort, sharing a recent experience: "There were three or four of us working on one patient recently," Dr. Cross said. "If that patient had been taken elsewhere, they likely wouldn’t have survived because there wouldn’t have been enough staff available. Another doctor might have taken them to surgery, but they wouldn’t have had the extra hands needed.”

Beyond the Numbers: The Real Impact of Specialized Care

The trauma team at OU Health isn't just extensive, it is also highly specialized. All trauma surgeons at OU Health are "double-boarded," meaning they're certified in both general surgery and surgical critical care. Half of them have completed two-year fellowships, an extra year specifically in trauma surgery beyond the standard requirement.

"Residency gives you a broad foundation," Dr. Cross said. "But during fellowship, you refine your skills—learning how to manage severely injured patients, make critical decisions, and perform complex surgeries."

This specialized training translates directly to patient care

Last year, OU Health treated 9,000 trauma patients, admitting 3,500 for specialized care.

• The orthopedic trauma team alone performed 3,000 surgeries in a single year, averaging 8 complex orthopedic procedures every day.
• The trauma team manages 2,000 traumatic brain injuries annually, from mild concussions to severe cases requiring emergency neurosurgical interventions and round-the-clock monitoring by specialized neurocritical care teams.
• Some of the most complex cases require 13+ operations and 20 different surgeons working together to save a single life.
• Six dedicated trauma bays and a dedicated trauma operating room available 24/7. Patients have access to the operating room within minutes of arrival.

“We also do multi-disciplinary rounds every day to bring nursing, providers, and case management together to assist with achieving optimal outcomes for our trauma patients,” said Dr. Cross.

This is the reality of high-level trauma care.

A System That Never Sleeps: How Trauma Activations Work

At OU Health, the trauma system is always at the ready.

On a typical night at 3 a.m., while most of Oklahoma sleeps, OU Health's trauma bay can transform from quiet to controlled action in seconds. When a Level I trauma activation comes in — perhaps a multi-vehicle crash with several critical patients — trauma surgeons, orthopedic specialists, neurosurgeons and dozens of support staff converge on the trauma bay ready to respond.

• Trauma surgeons are bedside within 15 minutes, 24/7.
• CT scans happen within 30 minutes of arrival – not hours.
• Blood products are prepped instantly, sometimes requiring 50+ units for a single patient.
• Multiple operating rooms run simultaneously to handle severe cases.
• Regular disaster drills ensure readiness for mass casualty events.

Dr. Cross explained that a high-performing and experienced trauma team can deliver results because expertise, experience and refined processes matter.

"The key is that the Trauma operating room is not a location, but a concept,” said Dr. Cross. “The OR has one room with staff available 24/7 to run purely emergent OR cases. In addition, we have 36 regular-staffed rooms during the day, and at night, we have three more that can run continuously. The biggest point is that we have redundancy in our system to continually call in backup.”

This means that no matter the time of day, no matter the emergency, OU Health is prepared.

Why This Matters: The Golden Hour

In trauma medicine, the first 60 minutes after injury is known as the “Golden Hour,” the critical window where rapid intervention can mean the difference between life and death.

For rural Oklahomans, understanding the capabilities of different trauma centers can be a life-or-death decision.

• If a patient with a traumatic brain injury is taken to a lower-level hospital without neurosurgical capabilities, they may lose critical time in a secondary transfer.
• If a severe car crash victim arrives at a facility without a dedicated trauma team, their chances of survival may decrease.
• For patients suffering from internal bleeding, the ability to stop hemorrhaging immediately is essential.

That’s why OU Health’s Level I Trauma Center is not just an advantage, it’s a necessity for Oklahoma. For the patients treated every day at OU Health’s Level I Trauma Center, the depth of expertise means:

• Immediate access to every specialty needed, without waiting for transfers
• Surgeons who have seen your specific injury pattern dozens, if not hundreds of times
• Blood products and specialized equipment ready before you arrive
• A team accustomed to working together under pressure
• Follow-up carefrom the same specialists who performed your initial treatment

"We care for Oklahomans in their worst moments," Dr. Cross said. "We've had great wins. At the end of the day, would I want to be anywhere else? Absolutely not. I wouldn’t do trauma in this state if I weren’t at OU Health."

As Oklahoma's only Level I Trauma Center, OU Health continues to stand ready for whatever comes through its doors. From everyday accidents to once-in-a-generation disasters, OU Health’s Level I Trauma Center provides comprehensive, specialized care when every second counts.

Learn more about trauma and injury care at OU Health’s Level I Trauma Center.