A Recipe for Better Trauma Care

"Every US resident should have the best possible chance for survival and functional recovery after injury. When it comes to trauma care, where people live ought not to determine if they live."

Up to 20 percent of all trauma deaths occurring in the United States could be prevented through better care—this would have saved about 30,000 people in 2014 alone—and the way to accomplish that is to integrate military and civilian trauma care systems, a report from the National Academies of Sciences, Engineering, and Medicine recommends. The report suggests the integration should be headed by the White House and is needed to reach the national goal of zero preventable deaths after injury.

The authors found the quality of care in our current military and civilian trauma care systems varies greatly depending on when and where the victim is injured, and that mass casualty incidents and increasing foreign and domestic threats make it more urgent to translate wartime lessons to civilian trauma systems. The integration should set up a national trauma care system, they wrote, adding that Congress, in consultation with HHS, should help ensure that prehospital care (including EMS) is included as a seamless component of health care delivery, rather than being viewed and paid as merely transportation providers.

They reported that the leading cause of death for Americans under age 46 is trauma—a disabling or life-threatening physical injury that results from an event such as a motor vehicle crash, gun violence, or fall. In 2013, trauma cost approximately $670 billion in medical expenses and lost productivity.

The report was prepared by the Committee on Military Trauma Care's Learning Health System and its Translation to the Civilian Sector, whose chair, Dr. Donald M. Berwick, M.D., president emeritus and senior fellow at the Institute for Healthcare Improvement, co-wrote an editorial for JAMA that concluded: "The progress made by the military's trauma system by applying learning health system principles is remarkable but fragile. Valuable wartime advances and lessons learned are at risk of being lost, and regression and inconsistency do a great disservice to the US Armed Forces service members. In addition, the hundreds of thousands of civilians who have sustained trauma deserve the benefits of care improvements achieved in military medicine. The nation should and, with proper leadership, can do better for the soldiers, sailors, airmen, and marines it sends into harm's way. And every US resident should have the best possible chance for survival and functional recovery after injury. When it comes to trauma care, where people live ought not to determine if they live."

This article originally appeared in the August 2016 issue of Occupational Health & Safety.

About the Author

Jerry Laws is Editor of Occupational Health & Safety magazine, which is owned by 1105 Media Inc.

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