Study: 20% of trauma deaths preventable, looking to the military for answers

Accreditation Insider, June 21, 2016

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A new study by The National Academies of Sciences, Engineering, & Medicine estimates that 20% of all trauma deaths (30,000 per year) could be prevented with better care. The report proposes applying the lessons learned by the military, which halved the rate of service members dying due to trauma injuries in Afghanistan between 2005 and 2013. 

Trauma is the leading cause of death for Americans under the age of 45, costing $670 billion and killing 148,000 in 2014. The panel writes that part of the problem is a lack of a single organization to oversee coordinating trauma care in the U.S. Instead, there’s a patchwork of response systems in place of varying levels of efficiency.

"The answer's always been to drive faster or fly faster. We're almost at the limit of that. Minutes really do count in these critically ill patients. But we can do things to stop bleeding, resuscitate better, while we're flying or driving faster," said panelist John Holcomb, MD, to The Associated Press.

As of 2011, only 16 states had even partially implemented the EMS triage guidelines created by the Centers for Disease Control and Prevention, the report finds. The triage guidelines determine the appropriate type of medical facility and care for patients. Those patients incorrectly sent to a hospital and then sent to a trauma center for their injuries are 25% more likely to die than those brought directly to the trauma center.

The panel urged the White House to integrate military and civilian trauma care systems to make sure the best practices are applied in both settings. Some of its recommendations include more frequent use of tourniquets and strengthening the role of EMTs and “prehospital” care. The panel also recommends getting military medical staff to rotate into civilian hospitals.

About two-thirds of Americans live within one hour of a Level I trauma center by car or plane. That said, only 25% of rural residents have that access to trauma care compared to 90% of urban residents. Panelists pointed out that in the case of Orlando terrorist attack could have been worse if there hadn’t been a major trauma center a few blocks away from the nightclub.

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