Emergency Medicine

James T. Niemann, MD
JAMA. 1987;258(16):2275-2276. doi:10.1001/jama.1987.03400160129037.
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Death due to trauma has come to be recognized as a major public health problem during the last quarter of a decade. Although accidental death rates have decreased by about 30% since 1950, trauma is still the nation's leading cause of morbidity and mortality in citizens under 45 years of age, and the psychological, physical, and financial impact of traumatic injury affects all ages, sexes, and ethnic groups. Despite the decline in mortality, the death rate from trauma still equals the rate of Vietnam War casualties and far surpasses the death rate from acquired immunodeficiency syndrome or cancer. The continuing decline in traumatic mortality and morbidity can be partly credited to educational efforts undertaken by emergency physicians with regard to alcohol and drug use, vehicle restraints, motorcycle helmet use, and regional trauma care.

For citizens past 45 years of age, cardiac arrest is the major cause of death. Out-of-hospital sudden


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