Trauma--the disease that was neglected. Progress: past and that to be

Sir Harold Stiles has a historic spot in the annals of trauma care to which he and his military colleagues so richly contributed. For this we honour him today. Tremendous progress has been achieved during our lifetime in the field of trauma. Injury prevention has been the most important facet with progress underway in the fields of gun control, seatbelts, motorcycle and bicycle helmets, child restraint seats, airbags and particularly alcohol restraint. Overall, traffic fatalities are being reduced. Of great importance is the need for de-emphasis and deglamorization of violence by television, movie, and news media. Improved prehospital care has taken the form of professionalism of emergency medical services comparable to that in law enforcement and fire services. Improved hospital care is resulting, in part, from the widespread development of trauma and burn centres. Continued progress is needed in each field, particularly in gun control, alcohol control, overall traffic accident prevention, and in the understanding of cerebral oedema after head injury. The teaching of the principles of trauma prevention and community organization for better emergency medical response should be introduced into the Health or Civics curriculum perhaps at the 5th or 6th grade level in elementary schools. Perhaps the greatest potential for progress in the field of trauma which we have witnessed in our lifetime may prove to have been the actions of the United Nations in Korea in 1950 and Kuwait in 1991, proclaiming that 'war will no longer be tolerated as an instrument of national aggression'.