Patients in rural areas are some of the most disadvantaged in the nation when it comes to trauma care thanks to lack of proximity to adequate facilities and a continuing shortage of surgeons. And, as California-based trauma surgeon Brent Eastman points out in his recently published article "Wherever the Dart Lands: Toward the Ideal Trauma System," that's just one aspect of what he considers to be a broken national trauma system. The article was published in the most recent edition of the Journal of the American College of Surgeons.

Eastman, who writes that the first hour is the most important when it comes to accessing quality care for trauma victims, calls trauma care in the U.S. both "fragmented" and "underfunded." He determined that 38 percent of states reported not even having a statewide trauma system in place, and found that the ones that did struggled to stay afloat because of money issues. 

In addition, the report reveals that for those under 45 years of age, trauma--unnecessarily--is the leading cause of death in the U.S. 

"Everyone living or traveling in the U.S. should be able to expect prompt transport to the appropriate level of care proportionate with their injuries," Eastman writes. "That's the vision when I say that wherever the dart lands on the map of the U.S., there should be a system to take care of your traumatic injury." 

Eastman calls military trauma systems in the Middle East--in Iraq and Afghanistan--"ideal" because of their proven ability to transport trauma victims from a battlefield setting to a combat support hospital in a quick and highly organized manner. He specifically writes about one such system, and how it saved the life of a Marine, despite the need to amputate one of the soldier's legs. 

To learn more:
- read this press release on the article
- here's Eastman's full article (registration required)

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