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Trauma Systems at Risk

Donald Trunkey, MD
JAMA. 1996;276(12):944-945. doi:10.1001/jama.1996.03540120022011.
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In 1976, the American College of Surgeons Committee on Trauma published "Optimal Resources for Care of the Seriously Injured."1 These guidelines initially defined the optimal qualities of a trauma center, but quickly evolved into guidelines for a trauma system. From the very beginning the Committee on Trauma was anxious to regionalize trauma care for several reasons. First and foremost was to provide consistent quality care to patients who often present in the middle of the night and/or when there are multiple patients. An analogy has been made between a trauma center and the fire department. Firefighters are required to be in house 24 hours a day to respond immediately to a fire to save property and sometimes even lives. The trauma system guidelines were designed to provide a similar type of response while reducing costs by preventing duplication and minimizing redundancy within the system. Trauma regionalization has become unique


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