Trauma - accidental or intentional injury - is a major health and social problem. It is still the chief cause of death in people between the ages of 1 and 38 years. In the United States, the mortality due to trauma between the ages of 15 and 24 years increased by 13% from 1960 to 1978. During the same period, the mortality for people aged 25 to 64 years declined by 16%. Murders have increased from 8464 in 1960, to 26 000 in 1982. The overall death rate of American teenagers and young adults is 50% higher than that of their counterparts in Britain, Sweden and Japan. Trauma affects young, productive citizens, and the estimated costs for death, disability and loss of productivity exceed $230 million a day. The most tragic statistic is that at least 40% of the deaths are needless and preventable if better treatment and prevention programs were available. Trauma deaths that might be prevented are those due to motor vehicle accidents, homicide, burns, and alcohol and drug abuse. In this paper suggestions for prevention are made. They include improved crash worthiness of motor vehicles, revocation of drunk drivers' licences, use of devices that limit drunk drivers, increased tax on alcohol and random breathalyser tests, and the use of seat belts and motorcycle helmets. Control of hand-guns and burn characteristics of cigarettes could also reduce deaths. The problems and issues in trauma care can be divided into two broad categories: system and professional. System problems include prehospital care, in-hospital care, rehabilitation and prevention. Professional problems include education, research, economics, and quality.(ABSTRACT TRUNCATED AT 250 WORDS)
创伤（意外或故意伤害）是一个重大的健康和社会问题。它仍是1至38岁人群死亡的主要原因。在美国，1960年至1978年间，15至24岁人群因创伤导致的死亡率上升了13%。同一时期，25至64岁人群的死亡率下降了16%。谋杀案从1960年的8464起增加到了1982年的26000起。美国青少年和年轻人的总体死亡率比英国、瑞典和日本的同龄人高50%。创伤影响着年轻且有生产力的公民，据估计，每天因死亡、残疾和生产力损失造成的费用超过2.3亿美元。最悲惨的数据是，如果能有更好的治疗和预防方案，至少40%的死亡是可以避免的。可能预防的创伤死亡包括因机动车事故、凶杀、烧伤以及酗酒和吸毒导致的死亡。本文提出了预防建议。这些建议包括提高机动车的防撞性能、吊销醉酒驾驶者的驾照、使用限制醉酒驾驶者的装置、提高酒精税并进行随机呼气酒精检测，以及使用安全带和摩托车头盔。控制手枪和香烟的燃烧特性也可以减少死亡。创伤护理中的问题可分为两大类：系统问题和专业问题。系统问题包括院前护理、院内护理、康复和预防。专业问题包括教育、研究、经济和质量。（摘要截选至250词）
