Related Guides on this Topic
You may also want to see this guide on related topic: Emergency Medical Services
Introduction
Trauma is often referred to as the neglected disease of the twenty-first century. HRSA reports that trauma related injuries in the United States are estimated to exceed 160,000 deaths each year, ranking as the 5th most common cause of death. Trauma is the leading cause of death for Americans 44 and younger; with children and youth comprising 25% of all traumatic deaths. But most alarmingly it is estimated that 60% of all injury deaths in the U.S. occur in rural areas - even though only 20% of the nation’s population live there.
Several agencies and organizations are actively seeking ways to reduce rural trauma. Standards have been created to support organized levels of trauma care, model plans are available to help states and regions develop trauma systems, and training programs are available to assist rural medical and ancillary staff become better prepared to provide trauma care. It is widely believed that with an integrated approach deaths due to trauma can be reduced much like other contemporary diseases.
Sources: Model Trauma System Planning and Evaluation. Health Resources and Services Administration (HRSA) and Report on Injuries in America, National Safety Council
Frequently Asked Questions
Tools
Access to Trauma Care
Web site
An interactive tool that allows the user to find the trauma care centers in their region and across the United States.
BrainLine.org
Web site
A resource on preventing, treating, and living with traumatic brain injury.
Center for Excellence in Rural Safety (CERS)
Web site
Provides citizen-centered research, training, and outreach to enhance rural safety and to meet the online and seminar training needs of rural transportation practitioners and policymakers.
EMTALA.com
Web site
A resource for current information about the Federal Emergency Medical Treatment and Active Labor Act, also known as COBRA or the Patient Anti-Dumping Law.
FARS (Fatality Analysis Reporting System) Encyclopedia
Web site
Provides statistical information on traffic fatalities including vehicle type, people involved and geographic location.
Fast Stats A to Z: All Injuries
Web site
Detailed statistics on all injuries in the U.S. that include: morbidity, ambulatory health care, hospital inpatient health care, and mortality data.
Find Your Local National Safety Council Chapter
Web site
A directory of the National Safety Council's network of state chapters. These local offices conduct safety, health and environmental efforts at the community level, providing training, conferences, workshops, consultation, newsletters, updates and safety support materials.
National Trauma Data Bank (NTDB)
Web site
A large aggregation of trauma registry data containing over 2 million records from trauma centers in the U.S. and Puerto Rico.
Report on Injuries in America
Web site
Lists the latest statistics from the National Safety Council on selected measures of unintentional injuries in the United States.
Safety & Health Fact Sheets
Web site
A list of fact sheets on critical safety and health topics including agricultural safety, school bus safety, and on the road safety.
Trauma System Self-Assessment Supplemental Tool: Benchmarks, Indicators, and Scoring
Web site
A tool to accompany HRSA's Model Trauma System Planning and Evaluation document, a guide to modern statewide trauma system development. This tool focuses on state and regional trauma system self-assessment.
Trauma Systems Consultation
Web site
Provides a variety of resources to assess and evaluate trauma systems. Includes consultative guidance for future trauma system development.
WISQARS (Web-based Injury Statistics Query and Reporting System)
Web site
An interactive database system that provides customized reports of injury-related data.
Maps & Map Collections
Map Tool to Assess Timely Access to Trauma Centers
Interactive
Geographic coverage: United States
Depicts Level I/II trauma center coverage throughout the United States. Identifies the availability of helicopter or ambulance for transport method.
Date: 2005
Regulations, Forms & Other Useful Documents
Contributing Factors and Issues Associated With Rural Ambulance Crashes: Literature Review and Annotated Bibliography
Author(s): Nels Sanddal, Steve Albert, Joseph Hansen, Douglas Kupas
Identified published literature that describes the frequency, epidemiology, etiology, typology, and cost of ambulance crashes generally and rural ambulance crashes specifically.
Date: 08 / 2008
Definitive Care Facilities
Sponsoring organization: American College of Surgeons
Section from the ACS publication "Resources for Optimal Care of the Injured Patient 2006." Lists and defines the levels of trauma care found in a trauma care system.
Date: 2006
Downwardly Mobile: The Accidental Cost of Being Uninsured
Author(s): Heather Rosen; Fady Saleh; Stuart Lipsitz; Selwyn O. Rogers Jr; Atul A. Gawande
Sponsoring organization: American Medical Association
Demonstrates that uninsured patients with traumatic injuries, such as car crashes, falls and gunshot wounds, were almost twice as likely to die in the hospital as similarly injured patients with health insurance. Details the results of a Harvard University study.
Journal citation: Archives of Surgery Volume 144 Issue 11
Date: 11 / 2009
Equipment for Ambulances
Sponsoring organization: American College of Emergency Physicians
Provides a list of standardized equipment for ambulances to optimize prehospital delivery of care and includes resources needed for appropriate terrorism preparedness.
Date: 2006
Farm Rescue and EMS: A State by State Directory
Sponsoring organization: Office of Rural Health Policy
A directory of contacts by state that specialize in farm rescue and response training.
Guide for Enhancing Rural Emergency Medical Services
Sponsoring organization: Transportation Research Board
Offers guidance for implementation of the AASHTO Strategic Highway Safety Plan. Provides strategies that can be employed to enhance rural emergency medical services.
Date: 2005
Guidelines for Field Triage of Injured Patients: Recommendations of the National Expert Panel on Field Triage
Sponsoring organization: Centers for Disease Control and Prevention
Describes the process and rationale used by the National Expert Panel on Field Triage to revise the "Decision Scheme" that guides EMS providers through four decision steps (physiologic, anatomic, mechanism of injury, and special considerations) to determine the most appropriate destination facility within the local trauma care system across the United States.
which serves as the basis for triage protocols for state and local EMS systems across the United States
Date: 01 / 2009
Longitudinal Trends in the U.S. Surgical Workforce 1981-2006: Overall Growth Has Stalled; General Surgery Supply Contracting
Author(s): Stephanie Poley, Daniel Belsky, Katie Gaul, Thomas Ricketts, Erin Fraher, George Sheldon
Sponsoring organization: American College of Surgeons Health Policy Research Institute
Discusses U.S. surgical workforce trends over the last 25 years and the problem of geographic distribution of surgeons in future years.
Date: 05 / 2009
Minnesota Statewide Trauma System
Author(s): Tim Held
Sponsoring organization: Minnesota Department of Health
A fact sheet providing background information about the Minnesota Statewide Trauma System.
Date: 01 / 2008
Minnesota Trauma System Performance Improvement Plan
Sponsoring organization: Minnesota Department of Health
Provides emergency medical services (EMS) agencies, trauma centers, trauma regions, and the Minnesota trauma program with a summary of the processes and activities required to measure, monitor, evaluate, and improve the process of trauma care and its outcome.
Date: 06 / 2009
Model Trauma System: Planning and Evaluation
Sponsoring organization: Health Resources and Services Administration
Provides trauma care professionals, public health officials, and health care policy experts with the direction to use the public health approach, a scientifically proven method, when developing and evaluating trauma systems.
Date: 02 / 2006
Quality Through Collaboration: The Future of Rural & Frontier EMS in the U.S. Health System
Sponsoring organization: Health Resources and Services Administration
Compares the findings of the Institute of Medicine's Future of Emergency Care reports with previous work on Rural Health and with the Rural and Frontier EMS Agenda for the Future and HRSA Model Trauma System Planning and Evaluation document. Identifies similarities and overlaps of the recommendations and approaches.
Date: 2007
Rural Health Facts: Traumatic Brain Injury
Sponsoring organization: University of North Dakota Center for Rural Health
Provides overview and statistics on traumatic brain injury in the United States, with some information specific to North Dakota.
Date: 2005
Rural Safety in Your State
Sponsoring organization: University of Minnesota
Lists rural crash statistics by state.
Date: 2005
Rural Trauma Victims Dying of the "Golden" Rule
Author(s): Julie Ardery
Describes how death rates from traumatic injury are higher in rural United States and identifies successful statewide trauma care systems with a focus on Maine.
Date: 08 / 2007
Surgical Deserts in the US: Places Without Surgeons
Author(s): Daniel Belsky, Thomas Ricketts, Stephanie Poley, Katie Gaul, Erin Fraher, George Sheldon
Sponsoring organization: American College of Surgeons Health Policy Research Institute
A fact sheet describing the current uneven distribution of surgeons across the United States, with more surgeons located in urban centers and fewer in rural communities.
Date: 07 / 2009
Traffic Safety Facts 2005 Data: Rural/Urban Comparison
Sponsoring organization: National Highway Traffic Safety Administration
Presents comparison data of rural versus urban traffic fatalities by year, location, speed and blood alcohol concentration.
Date: 2005
Trauma Systems Consultation
Sponsoring organization: American College of Surgeons
A tool for those individuals who are charged with evaluating trauma systems. Provides guidelines and plans for the implementation of trauma systems.
Date: 12 / 2007
Trauma Systems Save Rural Lives
Author(s): Candi Helseth
Sponsoring organization: Rural Assistance Center
Discusses organized trauma care systems, which are critical to reducing mortality and morbidity in rural areas. Highlights include how access to trauma care varies by state, how rural hospitals play a role in trauma care, and a future goal of having coordinated care nationwide.
Journal citation: Rural Monitor
Date: 11 / 2007
Organizations
American Association for the Surgery of Trauma (AAST)
National organization
Established to further the study and practice of traumatic surgery in its various departments, in the United States and Canada.
American Board of Emergency Medicine (ABEM)
National organization
ABEM certifies qualifying physicians who specialize in Emergency Medicine and is a member board of the American Board of Medical Specialties (ABMS).
American College of Emergency Physicians (ACEP)
Nonprofit/Foundation
Represents physicians who practice emergency medicine. Provides a national report card that includes an assessment of the support that each state provides for its emergency medicine system.
American College of Surgeons (ACS)
National organization
A scientific and educational association of surgeons that was founded to improve the quality of care for the surgical patient by setting high standards for surgical education and practice.
American College of Surgeons Health Policy Research Institute (ACSHPRI)
Academic/Research
Studies and reports on issues related to the state of the surgical profession, the surgical workforce, and surgical utilization in the United States. Provides advice, data analysis, and research for surgical professional associations and boards, policymakers, and the health services research community.
American Trauma Society (ATS)
National organization
An organization supporting trauma care and trauma prevention in the United States as well as advocate for trauma victims and their families.
Brain Trauma Foundation (BTF)
National organization
Mission is to improve the outcome of Traumatic Brain Injury (TBI) patients by developing best practice guidelines, conducting clinical research and educating medical personnel.
ChildTrauma Academy (CTA)
National organization
Helps improve the lives of traumatized and maltreated children - through education, service delivery and program consultation.
International Roundtable on Community Paramedicine (IRCP)
International organization
Comprised of delegates from various countries and regions dedicated to exploring the promotion and better delivery of health care through the utilization of traditional and non-traditional models of care.
National Association of State EMS Officials (NASEMSO)
National organization
Provides leadership and support to develop effective EMS systems throughout the nation and formulate national EMS policy, and to foster communication and sharing among state EMS directors.
National Center for Injury Prevention and Control (NCIPC)
Federal government
Works to reduce morbidity, disability, mortality, and costs associated with injuries. Part of the Centers for Disease Control and Prevention.
National Highway Traffic Safety Administration (NHTSA)
Federal government
Works to reduce deaths, injuries and economic losses resulting from motor vehicle crashes. Part of the U.S. Department of Transportation.
National Safety Council (NSC)
National organization
Works to educate and influence people to prevent accidental injury and death. Raises awareness about safety issues.
Orthopaedic Trauma Association (OTA)
International organization
Promotes excellence in care for the injured patient, through provision of scientific forums and support of musculoskeletal research and education of Orthopaedic Surgeons and the public.
Rural Emergency Medical Services & Trauma Technical Assistance Center (REMSTTAC)
Federal government
Serves as a national focal point for the dissemination of information on rural and frontier emergency medical services (EMS) and trauma care. REMSTTAC can be accessed by a broad range of rural and frontier EMS providers including federal grant recipients, state EMS and rural health offices, and their constituencies including rural hospitals and communities.
Society of Trauma Nurses (STN)
International organization
A membership-based, non-profit organization whose members represent trauma nurses from around the world. Members are nurses involved in trauma care in clinical, administrative, research and educational roles.
Terms & Acronyms
Benchmark Global overarching goals, expectations, or outcomes. In the context of the trauma systems, a benchmark identifies a broad system attribute.
Casualty Any person who is declared dead, missing, injured, or ill as a result of an incident.
Catastrophic Incident Any natural or man-made disaster that results in extraordinary levels of mass casualties, damage, or disruption severely affecting the population, infrastructure, environment, economy, national morale, and/or government functions.
Comprehensive trauma care system A coordinated inclusive system of care for the injured that encompasses all phases of care, from the prehospital setting to rehabilitation services and follow-up care. Such systems include data systems for injury surveillance and prevention as well as for performance measurement and improvement.
Definitive care Medical care intended to improve rather than stabilize a patient's condition. It includes the full range of preventive, curative acute, convalescent, restorative, and rehabilitative medical care leading to rehabilitation.
Golden hour The brief span of time just after a serious injury; survival usually depends on whether someone receives skilled critical care within those first 60 minutes.
Injury Physical harm or damage to the body resulting from the transfer of or exposure to mechanical, thermal, electrical, or chemical energy or from the absence of such essentials as heat or oxygen.
Injury risk assessment The process employed to determine the likelihood that injury will result from an incident, taking into account the identification of the hazard type, population affected, severity of injury, and volume or number affected.
Mass casualty incident (MCI) A situation in which a large quantity or number of either physical injuries or deaths, or both, occur.
Trauma center A specialized hospital facility distinguished by the immediate availability of specialized surgeons, physician specialists, anesthesiologists, nurses, and resuscitation and life support equipment on a 24 hour basis to care for severely injured patients or those at risk for severe injury.
Trauma injury Acute physical injuries, including burns and head injuries, which pose a risk for death or long-term disability.
Trauma system A pre-planned, comprehensive, and coordinated statewide and local injury response network that includes all facilities with the capability to care for the injured.
Article Searches & Bibliographies
RAC Documents Search: Trauma care
An annotated list of all documents in the RAC database on the topic of rural mental health.
PubMed Database Search: Trauma and Rural articles
PubMed’s list of journal article citations with abstracts using the terms rural and trauma in the United States published in the last 10 years. Some citations have links to the full-text of articles through PubMed Central, through your library’s electronic and print holdings, or through the publisher (the latter may require a subscription or a pay-per-view charge). Check your local library for details about full text links or call your Regional Medical Library at 800.338.7657.
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