- Email: [email protected]
National highway traffic safety administration (NHTSA) notes
INJURY PREVENTION/NHTSA NOTES
National Highway Traffic Safety Administration (NHTSA) Notes
Commentators Timothy D. Peterson, MD, MPH Federico Vaca, MD, MPH From the Iowa Department of Public Health, Bureau of Emergency Medical Services, Des Moines, IA; and the Department of Emergency Medicine, University of California–Irvine, Center for Health Policy Research, Irvine, CA.
Section Editors Joan S. Harris, MPA National Highway Traffic Safety Administration Washington, DC Herbert G. Garrison, MD, MPH Department of Emergency Medicine The Brody School of Medicine East Carolina University Greenville, NC Federico Vaca, MD, MPH Department of Emergency Medicine University of California–Irvine Center for Health Policy Research Irvine, CA Timothy D. Peterson, MD, MPH Iowa Department of Public Health Bureau of Emergency Medical Services Des Moines, IA Reprints not available from the editors.
7 9 8
Trauma System Agenda for the Future [National Highway Traffic Safety Administration. Trauma system agenda for the future. Ann Emerg Med. 2003;41:798-799.]
Trauma is a disease with identifiable causes, established methods of treatment, and defined methods of prevention. Most emergency medicine practitioners understand that there is much that can and should be done to reduce the incidence of trauma and to improve trauma treatment in this country. The emotional and financial effects are devastating. Prevention activities could prevent many from experiencing trauma. For others, improved systems of care for the injured can increase the chances of optimal recovery. Regardless of the number of injured or the source of injury, advanced planning, preparation, and coordination are essential for the best response and care. In response to a growing trauma problem and ever-increasing trauma care challenges, an action plan was developed by a group of trauma stakeholders. This included the American Trauma Society, the National Highway Traffic Safety Administration (NHTSA), the Health Resources and Services Administration, the American College of Surgeons, the Ameri-
can College of Emergency Physicians, the Society of Trauma Nurses, the National Association of State EMS Directors, the National Association of EMS Physicians, and others. The action plan addresses trauma prevention improvement in injury care resulting from both day-to-day emergencies and disasters. This report from NHTSA contains the results of that effort. The “Trauma System Agenda for the Future” reflects ideas generated from literally hundreds of professionals based on decades of experience. These professionals believe this is the appropriate time to launch a new initiative to aggressively address trauma on all fronts, thereby making a difference to our country and to each victim or potential victim. The vision articulated in the document states: Trauma systems, when fully implemented throughout the US, will enhance community health through an organized system of injury prevention, acute care and rehabilitation that is fully integrated with the public health system in a community. Trauma systems will possess the distinct ability to identify risk factors and related interventions to prevent injuries in a community, and will maximize the integrated delivery of optimal resources for patients who ultimately
ANNALS OF EMERGENCY MEDICINE
41:6
JUNE 2003
NHTSA NOTES
need acute trauma care. Trauma systems will address the daily demands of trauma care and form the basis for disaster preparedness. The resources required for each component of a trauma system will be clearly identified, deployed and studied to ensure that all injured patients gain access to the appropriate level of care in a timely, coordinated and cost-effective manner.1
To realize this vision, the “Trauma System Agenda for the Future” identifies key issues in addressing 4 fundamental components of the trauma care system and 8 key infrastructure elements that are critical to trauma system success. The 4 fundamental components include: • Injury prevention • Out-of-hospital care • Acute care facilities • Posthospital care In addition to the fundamental operational components of the trauma system, the following key infrastructure elements must be in place to support any comprehensive trauma care system: • Leadership • Professional resources • Education and advocacy • Information management • Finances • Research • Technology • Disaster preparedness and response—conventional and unconventional The document contains the current status and a set of vision statements or recommendations for each of these areas. The report outlines the benefits of the plan’s successful implementation. This includes: 1. A reduction in deaths caused by trauma 2. A reduction in the number and severity of disabilities caused by trauma
JUNE 2003
41:6
3. An increase in the number of productive working years 4. Cost reductions 5. Reduced burdens on local communities and on the federal government 6. A decrease in the effect on “second victims”—families. Trauma is predictable. It happened yesterday, it is happening today, and it will happen tomorrow. Fortunately, some answers already exist, and there is tremendous consensus on this among trauma stakeholders. Multidisciplinary teams of professionals have outlined a plan to reduce death and disability from the disease of trauma. What they need now is support—support from policymakers, from other health providers, and from the community. Achieving this vision will serve thousands of Americans who are injured in single incidents across the nation on a daily basis, and will also add greatly to the readiness of the nation for potential future disasters. This is an urgent call for action. When it comes to trauma, time is truly a life and death matter. doi:10.1067/mem.2003.211
REFERENCE 1. Committee on Injury Prevention and Control, Institute of Medicine. Reducing the Burden of Injury: Advancing Prevention and Treatment. Washington, DC: National Academy Press; 1999.
Commentary: Trauma Systems: A Key Factor in Homeland Preparedness [Peterson TD, Vaca F. Commentary: trauma systems: a key factor in homeland preparedness. Ann Emerg Med. 2003;41:799-801.]
“Preparedness” is a buzzword heard commonly in these days of disasters, terrorism, and war. One of the major events we are preparing for is the care of multiple casualties.
ANNALS OF EMERGENCY MEDICINE
A key preparedness factor in the care of many injured people is a well-functioning trauma system. When fully realized, the recently released “Trauma System Agenda for the Future” will help the communities of our country be better prepared for the worst. In this era when homeland security and safety is ever on people’s minds, the “Trauma System Agenda for the Future,” which was coordinated by the American Trauma Society and supported by the National Highway Traffic Safety Administration, provides a clear vision for addressing the fundamental components and infrastructure elements that are critical to trauma system success. Even without disasters or terrorist events, traumatic injury remains a significant health problem. Unintentional injury is the leading cause of death in the United States for people between the ages of 1 and 34 years.1 Annually, these injuries rob the nation of approximately 4 million years of potential life.2 There are as many as 148,000 trauma deaths in the United States each year, with direct and indirect health care costs estimated at $260 billion. Nearly 60 million people are injured in the United States annually, and injury accounts for 1 in 6 hospital admissions.3 The most common fatal injuries in this country result from motor vehicle crashes, followed closely by gunshot wounds. In 2001, there were 42,116 people who died as a result of motor vehicle crashes, and 3 million more were injured.4 Driving while impaired by alcohol is the most frequent cause of fatal motor vehicle crashes and accounts for approximately 40% of traffic fatalities.5 Many injured people require medical care for their injuries. Those with the most serious and severe injuries are better served by a trauma system. The “Trauma System Agenda for
7 9 9
National Highway Traffic Safety Administration (NHTSA) Notes
Commentators Timothy D. Peterson, MD, MPH Federico Vaca, MD, MPH From the Iowa Department of Public Health, Bureau of Emergency Medical Services, Des Moines, IA; and the Department of Emergency Medicine, University of California–Irvine, Center for Health Policy Research, Irvine, CA.
Section Editors Joan S. Harris, MPA National Highway Traffic Safety Administration Washington, DC Herbert G. Garrison, MD, MPH Department of Emergency Medicine The Brody School of Medicine East Carolina University Greenville, NC Federico Vaca, MD, MPH Department of Emergency Medicine University of California–Irvine Center for Health Policy Research Irvine, CA Timothy D. Peterson, MD, MPH Iowa Department of Public Health Bureau of Emergency Medical Services Des Moines, IA Reprints not available from the editors.
7 9 8
Trauma System Agenda for the Future [National Highway Traffic Safety Administration. Trauma system agenda for the future. Ann Emerg Med. 2003;41:798-799.]
Trauma is a disease with identifiable causes, established methods of treatment, and defined methods of prevention. Most emergency medicine practitioners understand that there is much that can and should be done to reduce the incidence of trauma and to improve trauma treatment in this country. The emotional and financial effects are devastating. Prevention activities could prevent many from experiencing trauma. For others, improved systems of care for the injured can increase the chances of optimal recovery. Regardless of the number of injured or the source of injury, advanced planning, preparation, and coordination are essential for the best response and care. In response to a growing trauma problem and ever-increasing trauma care challenges, an action plan was developed by a group of trauma stakeholders. This included the American Trauma Society, the National Highway Traffic Safety Administration (NHTSA), the Health Resources and Services Administration, the American College of Surgeons, the Ameri-
can College of Emergency Physicians, the Society of Trauma Nurses, the National Association of State EMS Directors, the National Association of EMS Physicians, and others. The action plan addresses trauma prevention improvement in injury care resulting from both day-to-day emergencies and disasters. This report from NHTSA contains the results of that effort. The “Trauma System Agenda for the Future” reflects ideas generated from literally hundreds of professionals based on decades of experience. These professionals believe this is the appropriate time to launch a new initiative to aggressively address trauma on all fronts, thereby making a difference to our country and to each victim or potential victim. The vision articulated in the document states: Trauma systems, when fully implemented throughout the US, will enhance community health through an organized system of injury prevention, acute care and rehabilitation that is fully integrated with the public health system in a community. Trauma systems will possess the distinct ability to identify risk factors and related interventions to prevent injuries in a community, and will maximize the integrated delivery of optimal resources for patients who ultimately
ANNALS OF EMERGENCY MEDICINE
41:6
JUNE 2003
NHTSA NOTES
need acute trauma care. Trauma systems will address the daily demands of trauma care and form the basis for disaster preparedness. The resources required for each component of a trauma system will be clearly identified, deployed and studied to ensure that all injured patients gain access to the appropriate level of care in a timely, coordinated and cost-effective manner.1
To realize this vision, the “Trauma System Agenda for the Future” identifies key issues in addressing 4 fundamental components of the trauma care system and 8 key infrastructure elements that are critical to trauma system success. The 4 fundamental components include: • Injury prevention • Out-of-hospital care • Acute care facilities • Posthospital care In addition to the fundamental operational components of the trauma system, the following key infrastructure elements must be in place to support any comprehensive trauma care system: • Leadership • Professional resources • Education and advocacy • Information management • Finances • Research • Technology • Disaster preparedness and response—conventional and unconventional The document contains the current status and a set of vision statements or recommendations for each of these areas. The report outlines the benefits of the plan’s successful implementation. This includes: 1. A reduction in deaths caused by trauma 2. A reduction in the number and severity of disabilities caused by trauma
JUNE 2003
41:6
3. An increase in the number of productive working years 4. Cost reductions 5. Reduced burdens on local communities and on the federal government 6. A decrease in the effect on “second victims”—families. Trauma is predictable. It happened yesterday, it is happening today, and it will happen tomorrow. Fortunately, some answers already exist, and there is tremendous consensus on this among trauma stakeholders. Multidisciplinary teams of professionals have outlined a plan to reduce death and disability from the disease of trauma. What they need now is support—support from policymakers, from other health providers, and from the community. Achieving this vision will serve thousands of Americans who are injured in single incidents across the nation on a daily basis, and will also add greatly to the readiness of the nation for potential future disasters. This is an urgent call for action. When it comes to trauma, time is truly a life and death matter. doi:10.1067/mem.2003.211
REFERENCE 1. Committee on Injury Prevention and Control, Institute of Medicine. Reducing the Burden of Injury: Advancing Prevention and Treatment. Washington, DC: National Academy Press; 1999.
Commentary: Trauma Systems: A Key Factor in Homeland Preparedness [Peterson TD, Vaca F. Commentary: trauma systems: a key factor in homeland preparedness. Ann Emerg Med. 2003;41:799-801.]
“Preparedness” is a buzzword heard commonly in these days of disasters, terrorism, and war. One of the major events we are preparing for is the care of multiple casualties.
ANNALS OF EMERGENCY MEDICINE
A key preparedness factor in the care of many injured people is a well-functioning trauma system. When fully realized, the recently released “Trauma System Agenda for the Future” will help the communities of our country be better prepared for the worst. In this era when homeland security and safety is ever on people’s minds, the “Trauma System Agenda for the Future,” which was coordinated by the American Trauma Society and supported by the National Highway Traffic Safety Administration, provides a clear vision for addressing the fundamental components and infrastructure elements that are critical to trauma system success. Even without disasters or terrorist events, traumatic injury remains a significant health problem. Unintentional injury is the leading cause of death in the United States for people between the ages of 1 and 34 years.1 Annually, these injuries rob the nation of approximately 4 million years of potential life.2 There are as many as 148,000 trauma deaths in the United States each year, with direct and indirect health care costs estimated at $260 billion. Nearly 60 million people are injured in the United States annually, and injury accounts for 1 in 6 hospital admissions.3 The most common fatal injuries in this country result from motor vehicle crashes, followed closely by gunshot wounds. In 2001, there were 42,116 people who died as a result of motor vehicle crashes, and 3 million more were injured.4 Driving while impaired by alcohol is the most frequent cause of fatal motor vehicle crashes and accounts for approximately 40% of traffic fatalities.5 Many injured people require medical care for their injuries. Those with the most serious and severe injuries are better served by a trauma system. The “Trauma System Agenda for
7 9 9