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The Evolution of Trauma Systems

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Damage Control Management in the Polytrauma Patient

Abstract

By any measure, injury is a serious public health problem. Worldwide, road traffic injuries are the leading cause of death among the young (aged 15–29 years), responsible for over a million deaths per year [1]. In the United States, unintentional injury is the leading cause of death for persons under the age of 45 years and is among the top ten causes of death for all decades of life [2], a pattern that has not changed significantly in decades (Fig. 1.1). Overall, injury is responsible for almost a third of all years of potential life lost. Moreover, it is a substantial economic burden [3]. In real numbers, highway transportation-related events in the United States were responsible for about 2.2 million injuries and 33,000 deaths in 2010 [4]. And yet, there is no focused public health policy at the federal level to address the problem of injury in a systematic fashion. Moreover, state and regional approaches are nonuniform, ranging from the very robust to the nonexistent. This lack of policy-level response is not universal. By comparison, the 2014 West African Ebola outbreak drew tremendous headlines and produced a massive public health response worldwide, despite accounting for only about 23,000 identified cases and about 9,800 deaths worldwide in its first year, according to CDC statistics [5] (Fig. 1.2). Over 50 years after Accidental Death and Disability: The Neglected Disease of Modern Society [6] was published by the National Academy of Science, injury remains the “neglected epidemic [6]” of modern society.

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Notes

  1. 1.

    In fact, prior to the advent of Social Security in the 1930s, the provision of aid to needy populations was felt to be completely outside the Constitutional mandate of the Federal government.

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Author information

Authors and Affiliations

  1. Division of Trauma, Burns, Acute and Critical Care, Department of Surgery, Weill Cornell Medicine, New York, NY, USA

    Robert J. Winchell MD, FACS

  2. Trauma Center, New York-Presbyterian Weill Cornell Medical Center, New York, NY, USA

    Robert J. Winchell MD, FACS

  3. Trauma Systems Evaluation and Planning Committee, American College of Surgeons Committee on Trauma, Chicago, IL, USA

    Robert J. Winchell MD, FACS

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  1. Robert J. Winchell MD, FACS
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Correspondence to Robert J. Winchell MD, FACS .

Editor information

Editors and Affiliations

  1. Department of Trauma, Zurich University, Zurich, Switzerland

    Hans-Christoph Pape

  2. Division of General Surgery, University of Pittsburgh, School of Medicine, Pittsburgh, Pennsylvania, USA

    Andrew B. Peitzman

  3. Department of Surgery, Division of Acute Care Surgery, University of Rochester, Medical Center, Rochester, New York, USA

    Michael F. Rotondo

  4. Department of Academic Trauma & Orthopaedics, University of Leeds, Leeds, West Yorkshire, United Kingdom

    Peter V. Giannoudis

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Winchell, R.J. (2017). The Evolution of Trauma Systems. In: Pape, HC., Peitzman, A., Rotondo, M., Giannoudis, P. (eds) Damage Control Management in the Polytrauma Patient. Springer, Cham. https://doi.org/10.1007/978-3-319-52429-0_1

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  • DOI: https://doi.org/10.1007/978-3-319-52429-0_1

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  • Online ISBN: 978-3-319-52429-0

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