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Trauma at Skyaid  updated 10/30/02

It appears that trauma centers with high volume of business can be very cost effective and "life-effective".  Trauma centers are not uniformly available in the US, perhaps because they are not effective for low-volume operation.  Trauma centers with low volume (less than 1 life-threatening injury per day)  are not as effective, and are sometimes closed.  These closures will happen more frequently in the future as  "economic measures become the principle criterion" with the evolution to for-profit hospitals.

Internal trauma wounds might be cauterized by High Intensity Focused Ultrasound (HIFU) before arriving at a hospital     By a Univ of Wash.Bioengineer.   Dawn Aug 14, 2001    added 10/06/01

Trauma deaths happen about 10% as often as deaths due to heart disease, but trauma deaths subtract about 10 times as many years from a person's life (45 years vs. 5 years)  Thus Skyaid might save more life-years reducing trauma deaths than reducing deaths due to heart disease.   click here for references  added 4/19/01

Prehospital trauma deaths can be reduced if response fast, but not cost effective currently  added 1/26/01

Fast response time reduces trauma deaths 6 abstracts added 12/28/00

Trauma Organization  added 06/24/01
http://www.trauma.org/
Their guide to the internet http://www.trauma.org/resources/guide-intro.html
Their links to other trauma sites: http://www.trauma.org/webpointers.html
Scoop and Run - Their e-mail discussion from 1996 http://www.trauma.org/archives/scooop.html
Emergency services database of Internet sites http://www.trauma.org/resources/guide-intro.html

Trauma deaths - 
numbers were taken from book: How we die 
  library.thinkquest.org/ 16665/aboutcauses.htm 
 added 06/24/01

 

 

 

 

USMAP_Trauma 94.gif (30192 bytes)Trauma centers are rare in non-metro counties 
see also USMaps

 

Journal of Trauma: Injury, Infection and Critical care

Effect of Prehospital Advanced Life Support on Outcomes of Major Trauma Patients Vol. 48 #4 April 2000

Conclusion: "ALS procedures can be performed by paramedics on major trauma patients without prolonging on-scene time, but they do not seem to improve survival."

A Historical Perspective of Trauma System Development in the United States Vol. 47 # 3 = September 1999 Supplement

"Payors also demand evidence that trauma systems are cost-effective.  Thus, the definition of a trauma system may evolve in the next decade, and economic measures may become the principle criterion."

Update on Trauma System Development in the United States Vol. 47 # 3 = September 1999 Supplement

Conclusion: "There has been significant progress, when compared with 1987 and 1993 evaluations in the number of states reporting the presence of trauma systems and meeting six or more key criteria.  Recent progress may be due to federal assistance for trauma system development available from 1991 until 1995."

"Of the 43 states with trauma systems, 30 states reported a single statewide trauma system."  
"Only 24 states indicated that one or more systems of trauma care functioned geographically in 100 percent of the state"

Review of Evidence Regarding Trauma System Effectiveness Resulting from Panel Studies Vol. 47 # 3 = September 1999 Supplement

A meta-analysis of 10 panel studies. 

Systematic Review of Published Evidence Regarding Trauma System Effectiveness Vol. 47 # 3 = September 1999 Supplement

"Injury causes, on average, 36 life years lost per death compared with 
12 years for heart disease and stroke combined, and 16 life-years lost for cancer."

"As a result of the injuries occurring {in the US} in 1985, 155,665 persons died 
(142,568 deaths in 1985 and 13,097 deaths in subsequent years."

"The authors agree the currently published literature limits our ability to assess trauma system effectiveness by excluding important components of care deliver (e.g. prehospital deaths) and failing to incorporate measures of short-term survival and functional outcome among patients surviving to hospital discharge. "

Advanced or Basic Life Support for Trauma: Meta-analysis and Critical Review of the Literature. October 2000

"Conclusion:  The aggregated data in the literature have failed to demonstrate a benefit for on-site ALS provided to trauma patients and support the scoop and run approach."  This is a meta-analysis of fifteen articles.

See also 

6 articles on Trauma reviewed by Skyaid in Dec 2000

Chance of surviving some traumas increases dramatically if treated at high-volume trauma centers