Coming Full Circle in Rural Trauma: Chronicling the Development and Testing of Communication Systems in Rural Trauma Networks
The importance of efficient triage and treatment of trauma patients has been evident since the Napoleonic Wars when Larrey developed the ambulance volantes (flying ambulance) as a means of reducing the interval time from injury to treatment (Trunkey 1983). The golden hour for treatment of trauma patients was first conceptualized by Cowley (1975) using French data obtained from the treatment of soldiers during World War I (Santy 1918). These data suggested that patients treated within the first hour of injury have a mortality rate of 10 percent, versus a mortality rate of 75 percent if treatment occurred within eight hours. Therefore, the reduction in time to definitive treatment is one of the most significant teaching points in surgical education.