The New Hampshire Trauma Review Board recognized Littleton Regional Hospital as a Level III Trauma Hospital in 1997. In order to qualify for status at this level, the Hospital needed the capability to admit certain complicated trauma injuries. In addition to trained trauma nurses and physicians, LRH needed facility capabilities in the areas of Surgical Services and Anesthesiology, Radiology, and Clinical Laboratory. Clare Wilmot, M.D. (surgeon), Edward Duffy, M.D. (Emergency Department Director), and Kurt Lucas (Emergency Department Manager-Coordinator) developed the trauma plan necessary for certification as a Level III Trauma Hospital.
Littleton Regional Hospital started a new paramedic program on February 6, 2001 as a result of receiving a federal grant in the amount of $100,000.00. Paramedics have special training to give emergency medical care to people who are seriously ill with the aim of stabilizing them before they are taken to the hospital. Paramedics are trained to give life-saving care. Given that many of the North Country towns do not have access to the level of care which paramedics give, Littleton Regional was able to get a fully equipped paramedic intercept vehicle with advanced level equipment. When the EMS dispatcher receives a critical call, the paramedic is able to either respond to the site of the incident or to an agreed upon location where the ambulance crew and the paramedic with the intercept vehicle are able to provide the care needed until they get to the hospital emergency room. This program ran until 2013.
With advances in prehospital care, search and rescue organizations also play a key role in a hospital emergency department's ability to provide first class care. These volunteer organizations are particularly important in the Littleton Hospital service area, which includes the White Mountains, where many take advantage of outdoor activities year-round. The federal grant in 2001 also included funds to provide more training for those professionals involved in rescues in the environment; particularly treatment of patients with hypothermia. In the Littleton area, the Pemigewasset Valley Search and Rescue Team (PFSART), founded by Allan Clark in 2005, responds to requests from the NH Fish and Game and other public safety agencies. They assist with searches for lost or missing persons, operating primarily in Grafton County and the western White Mountains. The PFSART and other like organizations function as a team along with the EMS prehospital community to give the rescued the best possible chance of a full recovery once they reach the hospital.