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Surgeon Envisions Nationwide Trauma System

Cheryl Clark, for HealthLeaders Media, August 25, 2010

With so much success throughout the state, California trauma experts are aggressively working to create a system that would merge all five trauma regions throughout the state so those who might have an unintentional injury in an area without a nearby hospital, or without one with teams and equipment ready to go in 10 minutes, Eastman tells me.

To prove his point on how trauma systems save lives, Eastman recently superimposed three maps to show comparative death rates from motor vehicle and bicycle accidents across the country.  A large swath of the non-coastal West, Montana, Wyoming, New Mexico and Arizona, Oklahoma, Kansas, Nebraska, and major portions of states straddling the Mississippi Delta, Louisiana, Mississippi, Alabama and Arkansas are colored in red, which indicates highest death rates per 100,000 of 28 to 87 or orange, with death rates or 23 to 28.

"The areas where it took longer than 60 minutes to get to a trauma center, the death rate was significantly higher," he says.

Areas in blue had the lowest vehicle death rates of 4.89  to 13.66, such as Southern and San Francisco Bay Area in California, virtually all of New England and the states along the coast of Lake Michigan.  Those are the areas with interlocking trauma systems and transfer agreements with smaller hospitals that may be the first to receive critically injured patients.

With a second map, Eastman superimposed long travel times to get to a trauma center with death rates per 100,000.  That too showed a correlation between longer times and more death.

And in the third map he superimposed again the number of surgeons by county. 

The counties with longer distances to a trauma center, fewer surgeons and higher death rates match with amazing accuracy, Eastman showed.

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