Current Trauma Status Report - Southern Nevada Health District

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• Disaster Preparedness and Response - Conventional & Unconventional
National Overview
It has only been in the past 20 years that trauma systems have existed at all. The need for improved
emergency treatment was reported in research as early as the late 1950s. 3 Additionally, the benefits of
immediate treatment of injuries had become apparent from the experience of treating injured soldiers
during the Korean and Vietnam wars. However, the first major step toward the development of trauma
systems came in 1966, when the National Academy of Sciences and National Research Council
published a white paper entitled Accidental Death and Disability: The Neglected Disease of Modern
Society. 4 This report identified significant deficiencies in the provision of care for injured patients in
this country, and it was instrumental in spurring the development of systems of trauma care. That
same year, the 1966 Highway Safety Act was enacted, reinforcing the states' authority to set standards,
regulate EMS and implement programs designed to reduce injury.
In the early planning years urban hospitals affiliated with medical schools had the staffing resources to
provide timely treatment of injuries, but others did not. Illinois was a leader with the establishment of
designated trauma centers in both urban and rural areas. In the following years, Maryland established
the Maryland Institute for Emergency Medical Services Systems (MIEMSS) and the first statewide
trauma system.
In 1973, the Emergency Medical Services Act (P.L. 93-154) was enacted to stimulate the development
of regional EMS systems. This Act contributed significantly to the growth of EMS infrastructure.
Fifteen program components were recognized as essential elements of an EMS system, including the
clear identification for the need of trauma systems. In 1981 this program ended and was folded into
the Preventive Health and Human Services (PHHS) Block Grant Program. Studies done in the late
1970s revealed high rates of preventable injury deaths. In 1983 West, Cales, et al, conducted a
comparison of preventable death rates pre- and post-trauma system implementation and found a
reduction from 73 percent to 9 percent. 5 Numerous additional studies by others have supported these
conclusions.
In 1985, the National Research Council and Library of Medicine published another white paper entitled
Injury in America—A Continuing Public Health Problem. 6 The report concluded that a great deal still
needed to be done for injury control. The report advocated increased resources for injury prevention
and led to the creation of an injury prevention center under the Centers for Disease Control (CDC).
Additional Injury Control Research Centers have since been established throughout the country.
After much debate and planning, The Trauma Care Systems Planning and Development Act of 1990
(P.L.101-590) was passed. The Act encourages state governments to develop, implement and improve
regional trauma systems. The primary focus of the Act is the development by each state of a trauma
care plan that takes into account national standards for the designation of trauma centers and for
3 Root GT, Christensen BH: Early surgical treatment of abdominal injuries in the traffic victim. Surg Gynecol Obstet 105:264, 1957; Van Wagoner FH:
Died in a hospital—A three year study of deaths following trauma. J Trauma 1:401, 1961.
4 National Academy of Sciences and National Research Council, Accidental Death and Disability: The Neglected Disease of Modern Society.
Washington, DC, 1966.
5 West JG, Cales RH, Gazzaniga AB: Impact of regionalization—The Orange County experience. Arch Surg 118:740, 1983.
6 National Research Council and Library of Medicine. Injury in America—A Continuing Public Health Problem. Washington, DC, National Academy
Press, 1985.
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