Alongside these national efforts, state and local legislatures began to organize strategies to care for injured patients by using pre-hospital care systems to stabilize and deliver patients to major hospitals where appropriate care could be given. The “Emergency Medical Service Systems Act of 1973” became law and provided the first federal funds to establish EMS systems. Systems for and organized approach to trauma were beginning to solidify. Prehospital provider programs were formalized, emergency medical technicians (EMT) and other paramedical personnel were identified, and training programs were established. MIEMSS became the first organized, statewide, regionalized system in 1973. This collaboration, innovative in its origin, reduced trauma-related mortality by transporting critically injured patients from the field or regional hospitals via police helicopters to a dedicated trauma unit. In conjunction with Maryland State Police, the shock trauma unit launched the Maryland Institute for Emergency Medical Services System (MIEMSS). At a similar time, University of Maryland Hospital established its shock trauma unit and popularized the “golden hour” for trauma resuscitation. The Cook County Hospital in Chicago consolidated care of all trauma patients and developed a dedicated trauma team unit, gaining recognition as one of the nation's first trauma centers in 1966. With the care for the injured gaining momentum in the United States, local leaders began following suit as trauma systems emerged. With the outcomes of decreased fatality impossible to ignore, public awareness of traumatic injuries grew and led to a federal agenda for the general improvement of trauma care nationally. These mandates exemplified how traumatic injuries are in fact a preventable cause of death. With these efforts, there was a rapid decrease in motor vehicle fatalities within 5 years after its implementation. This report was the first of its kind to address injury as a neglected epidemic and the “leading cause of death in the first half of life's span.” It underscored the deficient emergency medical care capacity and pushed for the establishment of trauma registries, hospital trauma committees, and funding for trauma research.ĭuring the same year, the US federal government launched “The National Traffic and Motor Safety Act.” This effort required vehicle standards such as seat belts, improved road standards and public education of driver safety laws. While systematic care for the injured took its early roots in the military, the need for a structured trauma system did not receive civilian spotlight until the publication of “Accidental Death and Disability: The Neglected Disease of Modern Society” in 1966. Advances in rapid pre-hospital transport, resuscitation with blood products, surgical techniques and surgical critical care have all expanded from military experience. Ĭivilian trauma in the United States has in many ways followed the path of military systems. Trauma systems have developed into an organized, integrated approach aimed at providing severely injured patients expedient initial treatment with the intent to promote optimal care along a continuum, from prehospital care through rehabilitation, ultimately to provide the best outcome possible for the injured patient. The expansion of trauma systems within the United States blossomed after traumatic injuries were recognized as a solvable public health epidemic rather than unavoidable accidents. About 49,500 reported deaths in 2019 were violent in nature. According to the Centers for Disease Control and Prevention, in 2020 there were about 278,000 deaths secondary to injury and about 22.9 million non-fatal injuries that required emergency department visits. Traumatic injury is a growing public health epidemic in the United States and globally. The work cannot be changed in any way or used commercially without permission from the journal. This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article. United States trauma system: Maryland focus. How to cite this article: Gupta S, Tannous A, Scalea T. Address: 22 South Greene Street, Baltimore, Maryland, 21202, USA. AShock Trauma Center Program in Trauma, Capital Region Health, University of Maryland, Baltimore, Maryland, USAīShock Trauma Center Program in Trauma, University of Maryland, Baltimore, Maryland, USA.
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