Status of trauma center designation.

1) In 1986 20 states are designating trauma centers. 2) ACS guidelines appear to be the accepted standard. 3) Almost all of the states providing designation retain the power of final designation but allow individual hospitals to initiate the process. 4) Designation is usually based on actual capability and frequently requires a site visit team in which surgeons and emergency medicine physicians play a prominent role. 5) Designation appears to be for a finite period of time but half of the states do not provide for de-designation. 6) A national mandate is necessary for timely and uniform implementation of trauma center designation.