Commitment to trauma in a low population density area

Between January 1978 and March 1979, we conducted a prospective and retrospective study of 202 consecutive blunt trauma patients ages 11 to 92 years. All patients admitted through the trauma service to the intensive care units at LDS Hospital (Salt Lake City) from a low population density area were scored using the Injury Severity Score (ISS) and Glasgow Coma Score (GCS) and patients were categorized according to outcome. There were 30 deaths, for a mortality rate of 14.8%. Twenty-six patients had persistent morbidity, 12.9%. The mean ISS for death was 39; for morbidity, 36; and for patients who were successfully rehabilitated, 23. There were 119 patients with head injuries. The mean GCS was 7 for nonsurvivors, 10 for patients with morbidity, and 12 for rehabilitated patients. We conclude that commitment is a major factor in determining the effectiveness of any trauma system. We strongly encourage regionalization of trauma care and education of paramedics, emergency medical technicians, and physicians in the rapid triage of high-risk patients to a major trauma center.