ABSTRACT
In 1966, a report was published by the National Research Council, entitled “Accidental Death and Disability-The Neglected Disease of Modern Society” (1). This publication led to the passage of the 1966 Highway Safety Act, and subsequently to the establishment of the Emergency Medical Services (EMS) program by the Department of Transportation. In 1976, the American College of Surgeons (ACS) Committee on Trauma (COT) recommended guidelines for designing and implementing trauma centers be adopted (2). Since then, trauma centers have been established in numerous communities. A recent meta-analysis of level I trauma centers have shown a 15% improvement in patient outcomes since the implementation of these facilities (3). Numerous reasons are responsible for the improved outcomes, including the requirement to have an attending trauma surgeon present within 15 min of a seriously injured patient’s arrival to the Emergency Department (ED) (4,5). Similarly, a high-intensity model of critical care staffed by intensivists has been shown to decrease morbidity and mortality, and length of stay in both in the SICU and in the hospital overall (6-10).
