Cedars-Sinai Medical Center is marking 40 years since its designation as a Level I Trauma Center by the American College of Surgeons Committee on Trauma (ACS COT). Over this period, the hospital has seen significant changes in trauma care, according to Daniel Margulies, MD, director of Acute Care Surgery in the Jim and Eleanor Randall Department of Surgery at Cedars-Sinai.
Margulies highlighted how advancements such as improved imaging and minimally invasive procedures have enabled trauma surgeons to make more informed decisions under pressure. “One of the biggest advancements we’ve made is actually knowing when we can avoid an operation,” said Margulies, who joined Cedars-Sinai in the early 1990s and served as medical director of Trauma for over 25 years.
Cedars-Sinai was first designated a Level I Adult Trauma Center in 1984. After its most recent evaluation and recertification by ACS COT, it remains one of Los Angeles County’s longest-running Level I centers. Galinos Barmparas, MD, medical director of Trauma at Cedars-Sinai, stated: “Maintaining Level I status for our hospital ensures that patients in our community have access to a center capable of managing any injury, no matter the severity, with the full spectrum of subspecialty support. Patients can expect coordinated, expert and compassionate care delivered by a team that lives and breathes trauma readiness.”
Margulies noted that earlier in his career trauma patients often underwent exploratory surgery to determine diagnoses. With improvements in imaging technology such as faster CT scans and bedside ultrasound—including focused abdominal sonography in trauma (FAST) exams—clinicians are now able to assess critically ill patients more quickly and offer less invasive treatments when appropriate.
The types of injuries treated have also changed over time. “Before seatbelt laws were strictly enforced and airbags were required in cars, we saw a lot of head injuries and extreme traumas from ejection following motor vehicle collisions,” Margulies said. “Now that some of those safety measures are in place, we actually see more pedestrians hit by cars, potentially due to distracted driving.” He added that with an aging patient population, falls have become a more common cause of trauma.
The size of Cedars-Sinai’s trauma team has increased since new ACS rules for Level I centers took effect in 1999 requiring an attending surgeon onsite around the clock. “There were five of us who were attendings at that time, so I practically lived at the hospital,” Margulies recalled. The faculty now includes 11 attending surgeons—all fellowship-trained in surgical critical care—with plans for further growth.
Cedars-Sinai continues to undergo triennial evaluations by ACS COT for redesignation as a Level I center. Barmparas commented: “This reverification is both a validation and a reminder of the tremendous daily effort by our trauma team. It represents not just excellence in meeting national standards but a sustained commitment to continuous improvement and compassion in trauma care. Every verification cycle is an opportunity to reflect on how far we’ve come and how we can keep pushing the standard forward for our patients and community.”
Founded in 1902 and located in Los Angeles, California, Cedars-Sinai Medical Center admitted over 50,000 patients during 2022 according to its annual report . The hospital serves as both a pediatric facility and training institution under current president Thomas M. Priselac.
