Battlefield lessons for trauma care: National system could save 200K lives


Improved trauma care could prevent 20 percent of deaths from injuries such as gunshots or car accidents, according to a new report from the National Academies of Sciences, Engineering and Medicine.  

The report, co-authored by Donald Berwick, M.D., former administrator for the Centers for Medicare & Medicaid Services, calls for healthcare leaders to set a national goal of zero preventable deaths from injury. As a model for such a strategy, the report cites the U.S. Army’s 75th Ranger Regiment, which managed to nearly eliminate preventable deaths.

Between 2001 and 2011, if all trauma centers nationwide had achieved outcomes on the level of the top-performing centers, 200,000 fewer patients would have died, according to the report. As it stands, however, research shows all trauma providers are not created equal, with trauma centers serving a predominantly minority population seeing higher mortality rates.

To properly address trauma care, the authors write, healthcare needs a nationwide trauma care system that provides education across the entire continuum of trauma care, from the actual injury scene to rehabilitation and post-rehabilitation. Currently, “we do not have a cogent or well-designed research strategy on trauma care,” Berwick said in a public briefing on the report last week, according to Kaiser Health News.

Trauma care also needs a bigger research budget, according to the report; while trauma is the top cause of death for civilian Americans under 46, its research budget was less than 1 percent of the National Institutes of Health’s 2015 biomedical research budget.

In the wake of mass casualty events such as this month’s mass shooting in Orlando, Florida, which killed 49 people, the presence nearby of emergency personnel with battlefield experience provides a clear advantage.

"The tragedy is that a lot of this likely could be helped by that hard-won knowledge gained on the battlefield," John B. Holcomb, a retired colonel and chairman of surgery at the University of Texas Health Science Center, who served on the committee, told Stars & Stripes. "No one knows where the next Orlando is going to happen."

- download the report
- check out the KHN article
- read the Stars & Stripes article

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