AMERICAN COLLEGE OF SURGEONS 2009 Clinical Congress, October 11-15, 2009 -- Trauma care in the United States is so fragmented, overwhelmed and underfunded that the survival and recovery of those who suffer major trauma often depends on where they happen to be when they are injured. That was the conclusion voiced today during a signature speech at the 2009 Clinical Congress of the American College of Surgeons in Chicago.
High death rates in rural areas, a growing shortage of trauma surgeons and a disconnect between existing trauma systems and regional disaster preparedness plans add to a bleak picture of the state of trauma care in the U.S., said A. Brent Eastman, MD, FACS, vice-chair of the ACS Board of Regents and Chief Medical Officer and N. Paul Whittier Chair of Trauma of Scripps Health in San Diego. He delivered the organization's annual speech on trauma, the Scudder Oration on Trauma, "Wherever the Dart Lands: Toward the Ideal Trauma System."
"Coordinated, regionalized and accountable trauma systems are proven to get the right patients to the right hospital at the right time," said Dr. Eastman. "For victims of major trauma, access to timely, optimal care during the first 'golden' hour has been proven to save lives, restore function and prevent disability."
But Dr. Eastman pointed out during his presentation that there are many areas of our country, especially rural areas, not served by such systems. Assembling for the first time maps of the U.S. that show death rates due to trauma per 100,000 population, travel times to the nearest trauma center and populations of surgeons, he showed that a combination of a shortage of surgeons and gaps in regional trauma systems has stymied access to timely, appropriate trauma care in many areas of the country. This has led to unnecessarily high death rates due to trauma in those areas, and has contributed to the fact that trauma is the leading cause of death for those under the age of 45 in this country and in developing countries around the world.
In addition, Dr. Eastman revealed that in a survey this year of trauma surgeons in each state, nearly 40 percent of the U.S. population may not be covered by a statewide trauma system.