Accidents and trauma care--1983.

Except for categoric grants, the federal government has divested itself of financing emergency medical services. Now the leadership for regional planning of emergency medical services must come from the state, usually from the health department. If we are to obtain improved hospital care of trauma patients, it is critical that we separate hospitals that have made a genuine commitment to the care of the multiply injured patient from hospitals that have not in order to avoid the tragedy of patients being delivered to hospitals that have inadequate resources or commitment or organization to meet the needs of such patients. The most widely accepted categorization format for determining hospitals' ability to provide care for the trauma patient is that devised by the National Committee on Trauma of the American College of Surgeons. In order to be a Level I or II trauma center in that categorization format, a hospital has to show evidence of a fiscal and organizational commitment on the part of the hospital administration and staff to provide care to multiply injured patients sufficient to match the needs of that patient. The experience in Germany and in various counties of the United States that have regionalized trauma care provides the expectation that 25 percent or more of patients now dying of trauma could be saved. Professional organizations have a major role in supporting improved care for trauma patients by providing support and expertise to the EMS division of the state health department as well as developing national standards for hospital care of injured persons, equipment lists for ambulances, and training standards, as has been done by the American College of Surgeons Committee on Trauma.