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OHSU Trauma Surgeon Provides Insight Into JAMA Inventory of Trauma Centers Nationwide

   Portland, Ore.

Donald Trunkey, M.D, an internationally recognized expert on trauma systems, hopes this inventory will impact health policy

The number of trauma centers in the United States has doubled in the last 12 years, but there are still 15 states that don't have formalized trauma systems, putting their community's health at risk. That needs to change according to an editorial in the March 26 issue of the Journal of the American Medical Association written by Donald Trunkey, M.D., professor of surgery in the Oregon Health & Science University School of Medicine and an internationally recognized trauma surgeon. Trunkey's editorial comments accompany a published inventory of hospital trauma centers in the same edition of JAMA.

"The purpose of my comments is to emphasize some of the points made by the authors and how they could be applied to health care policy," wrote Trunkey, who helped develop Oregon¹s trauma system, the second to be established in the country in 1988.

The inventory provides the first comprehensive account of trauma centers in the United States since 1991, including their locations and level of care. Trunkey is encouraged that 35 states have trauma systems. But he is concerned that state emergency medical systems haven't limited the number of trauma centers based on need, resulting in an inefficient use of funding support and too many areas of the country without trauma care.

"Probably the most useful immediate good that could come from the inventory is to correct the geographic disparity and to get the remaining 15 states to establish their own trauma systems," wrote Trunkey.

Trunkey indicates in his editorial accompanying the article, that an inventory should be done annually and made public. In addition, he believes designated trauma centers should be listed in phone books, and states should be encouraged to post highway markers indicating nearby trauma centers.

His editorial points out the need to expand the inventory to include pre-hospital and rehabilitation care, both of which are vital pieces of the continuum of care. For example, like trauma care, standardized guidelines should be developed for emergency medical services across the country, Trunkey wrote.

As a former chief of surgery and chief of professional services at the only military hospital during the Gulf War, Trunkey agreed with the inventory authors' emphasis on the need to use this new comprehensive list for hospital preparedness and homeland security. Furthermore he wrote, trauma centers are more likely to have a highly trained emergency staff with expertise in weapons of mass destruction.

Overall, Trunkey believes the inventory is a valuable tool to help shape health care policy and serve as a valuable listing of trauma center levels for disaster preparedness.

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