American Trauma Society Research Articles

The Trauma Survivors Network: Survive. Connect. Rebuild.

Despite substantial improvements in trauma care, severe injuries often result in significant long-term consequences for otherwise young, healthy individuals. Providing patient-centered care and extensive psychosocial support services is difficult for trauma centers. In collaboration with researchers and clinicians, the American Trauma Society has developed the Trauma Survivors Network, a program incorporating self-management, peer support, timely access to information, and online social networking. Individually, these components have been proven effective in improving outcomes and quality of life and are widely used in nontrauma settings. To date, 70 representatives from 30 trauma centers have participated in training sessions conducted by the American Trauma Society. The Trauma Survivors Network provides a critical component of trauma care that can be adapted for local needs throughout the country. Implementation of these services is a necessary step in the development of comprehensive trauma systems that not only save lives but also reduce long-term disability among survivors.

SALT Mass Casualty Triage: Concept Endorsed by the American College of Emergency Physicians, American College of Surgeons Committee on Trauma, American Trauma Society, National Association of EMS Physicians, National Disaster Life Support Education Consortium, and State and Territorial Injury Prevention Directors Association

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The U.S. Trauma Surgeon’s Current Scope of Practice: Can We Deliver Acute Care Surgery?

The evolving discipline of acute care surgery as an expansion of trauma surgery is undergoing intense critique. As we envision this new paradigm of surgical practice, an evaluation of our current status across the nation's trauma centers is an essential step. The purpose of this study is to determine the practice patterns of trauma surgeons at major trauma centers throughout the United States. A survey was sent to the trauma directors of the 1,288 designated trauma centers in the United States, as listed by the American Trauma Society. As proposed, acute care surgery would encompass performing emergent abdominal, vascular, and thoracic trauma procedures as well as providing critical care. The addition of simple orthopedic and neurosurgical procedures has been considered. The survey response rate was 72% among the Level I/II/III centers (n = 515) with 92% of Level I, 72% of Level II, and 59% of Level III centers responding. Of the 169 Level I centers, 31 (18%) reported their trauma surgeons perform the full complement of thoracic, vascular, and abdominal cases. Trauma surgeons managed the full range of injuries at 11 (6%) of the 187 Level II centers and 7 (4%) of the 159 Level III centers. At these 49 centers, only 41% of surgeons perform elective thoracic and vascular cases. The remaining 466 centers enlist a combination of vascular and thoracic surgeons to manage trauma patients. Finally, trauma surgeons performed cranial burr holes at eight trauma centers, placement of ICP monitors at four, and open fracture washout at three trauma centers. The model of the acute care surgeon is attractive and timely, but only a limited number of trauma surgeons currently practice this proposed range of operative procedures; even fewer surgeons have an elective surgical practice to maintain key operative skills. Fellowship training programs need to incorporate vascular and thoracic procedures to enable the specialty of acute care surgery.

From the Feds: Research, programs, and products

From the Feds: Research, programs, and products

Survey Reveals Need To Strengthen Financial Viability Of State Trauma System: Texas Trauma System Viability

Texas—A recent survey of the state's leading Level 1 and 2 Trauma Centers reveals the need to ensure financial stability of the state's trauma system. Level 1 and Level 2 trauma centers are those few institutions statewide that have focused themselves to offer the highest level of trauma services to Texans critically injured on the highway, at work, at home, or in the community, regardless of insurance status. Many people do not realize the prevalence of traumatic injuries. Trauma is actually the leading cause of death in persons under 34 years of age, and is one of the leading causes of death and disability (American Trauma Society). Every 15 seconds in America a person sustains a traumatic brain injury (Traumagram, Summer 2000). Three in every 100 babies born will suffer a disability from injuries suffered in traffic accidents. Trauma victims are primarily those injured in motor vehicle accidents, falls, and bicycle or industrial accidents, and Texas has the highest number of annual motor vehicle deaths in the nation with 3,901 deaths (Texas Department of Health, 1999). The city of Houston alone in year 2000 posted 244 traffic deaths (an 8% increase over the prior year) and more deaths than from homicides (Houston Chronicle, January 1, 2001). Indeed, only 7 percent of all patients cared for in all Level 1 and 2 trauma centers sustained gunshot wounds (Texas Department of Health, 1998). Trauma centers, unlike other hospitals, will accept any severely injured patient needing the higher level of care services trauma centers offer, from either the scene of an accident or as a transfer from another facility, regardless of insurance status. Accordingly those who need and use trauma centers are overwhelmingly victims of accidents and not crimes, usually have jobs, and reflect the uninsured rate of the community. With the population of Texas cities continuing to grow and branch out along highway routes, it is ever more critical that our trauma centers are viably positioned as part of our state's emergency medical system, alongside ambulance and EMS services, police, and fire departments. The survey included responses from two-thirds of the state's fifteen non-military Level 1 and 2 trauma centers, including centers in Houston, Dallas, Fort Worth, Austin, San Antonio, Lubbock, and Tyler (Figure 1). Participants submitted selfreported financial information using definitions and a format consistent with the Cooperative Annual Survey of Hospitals conducted by the American Hospital Association, Texas Department of Health, and Texas Hospital Association. Eight of the ten facilities gave more detailed financial information for a two year period that allowed for further analysis of trauma trends. Respondents included private, notfor-profit hospitals which receive no financial tax support for operation of trauma centers, as well as county supported hospital districts which are struggling to care for growing numbers of uninsured patients. These trauma centers accept patients from local and distant communities, often delivered by ground or air ambulance from the scene of an accident or transferred from a community facility. In many cases these trauma centers are primary hospitals for medical schools, leaders in clinical research, pioneers in air ambulance services, and developers of lifesaving treatments. These medical centers are rigorously surveyed by the American College of Surgeons and licensed by the Texas Department of Health. Survey Reveals Need To Strengthen Financial Viability Of State Trauma System: Texas Trauma System Viability

Trauma care, trauma prevention, and the role of the American Trauma Society.

Trauma care, trauma prevention, and the role of the American Trauma Society.

The Status of the Trauma Coordinator Position

The trauma coordinator (TC) position is a vital link in the development and operations of trauma care systems. In 1992 and 1993, the American Trauma Society conducted a national survey of TCs to describe the roles and characteristics of the persons who hold those positions. Of 354 trauma coordinators identified in 46 states, more than three-fourths were employed by large hospitals designated as trauma centers. The typical TC was a woman 26 to 59 years old who held at least a bachelor's degree in nursing. Although new as TCs (mean, 3 years as TCs), the respondents averaged 14 years experience in nursing. Both full-time and part-time TCs worked longer hours than scheduled, often had supervisory responsibilities, and generally were in the nursing administration or the emergency department structure. Most TCs worked with computerized trauma registries that were used routinely in quality of care reviews.

The Status of the Trauma Coordinator Position

The trauma coordinator (TC) position is a vital link in the development and operations of trauma care systems. In 1992 and 1993, the American Trauma Society conducted a national survey of TCs to describe the roles and characteristics of the persons who hold those positions. Of 354 trauma coordinators identified in 46 states, more than three-fourths were employed by large hospitals designated as trauma centers. The typical TC was a woman 26 to 59 years old who held at least a bachelor's degree in nursing. Although new as TCs (mean, 3 years as TCs), the respondents averaged 14 years experience in nursing. Both full-time and part-time TCs worked longer hours than scheduled, often had supervisory responsibilities, and generally were in the nursing administration or the emergency department structure. Most TCs worked with computerized trauma registries that were used routinely in quality of care reviews.

Pan American Trauma Society Nurses

Pan American Trauma Society Nurses

Accidental death and disability: The neglected disease of modern society — Where is the fifth component?

As president of the American Trauma Society, Dr. Cowley was instrumental in developing the society's position paper, The Need for a National Trauma Institute, on which his lecture is based.

Trauma—A Controllable Disease in the 1980ʼs (Fourth Annual Stone Lecture, American Trauma Society)

Trauma—A Controllable Disease in the 1980's (Fourth Annual Stone Lecture, American Trauma Society): PDF Only

Trauma—A Controllable Disease in the 1980ʼs (Fourth Annual Stone Lecture, American Trauma Society)

Trauma—A Controllable Disease in the 1980's (Fourth Annual Stone Lecture, American Trauma Society): PDF Only

Why Not a National Institute for Trauma? (Third Annual Stone Lecture, American Trauma Society)

The Journal of Trauma: Injury, Infection, and Critical Care: May 1979 - Volume 19 - Issue 5 - p 354-357

The second annual William S. Stone Lecture of the American Trauma Society.

The second annual William S. Stone Lecture of the American Trauma Society.

The American Trauma Society

The American Trauma Society