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The foundation of trauma care started as a way to help those who weren't able to get advanced treatment, such as people who get hurt in war.

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Historical evidence shows us that this form of treatment dates back as far as 10,000 BC. Scientists found skulls in western Asia in the Tigers-Euphrates valley, these skulls showed evidence of trauma care being done. Possibly for a depressed skull fracture or a epidermal hematoma. Some skulls show these operations were done more then once. There is sufficient evidence to prove that these operations were a success.

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The Greeks however were the first to develop a trauma care system. After realizing how soldiers sustained wounds in battle (that can be lethal) greek physicians realized the need for a system of care when in combat. Wounded soldiers were taken to particular barracks, or ships, were they would receive the medical attention they needed. Yet the care for the wounded was harsh; wounds from arrows were removed by enlarging the injury and pushing the arrow through.

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Trauma Care in the United States (1861-1865)

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Trauma Care in the United States (1861-1865)

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Trauma care in the Unites States started to become a thing during the Civil War. Abraham Lincoln was the first president to set up a "trauma" system during the civil war although the idea of a trauma system during war did not become popular until World War I.

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Antonine De Page was a Belgium surgeon that changed the face of medicine on the battle field during World War I. At the start of the German invasion De Page escaped from his hospital in Belgium and moved to France. Under the request from Queen Elizabeth Antonine established a military hospital in La Panne, Belgium (just north of the French Border). Treatments at this hospital included gunshot wounds, debridement and repair of damaged tissue, and analysis of infected wounds.

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Antonine De Page established a orderly system of evacuating the injured from the battlefield to a hospital, this system was called Ordre de Triage. The triage system was broken into 5 different steps that the soldiers/medics would follow to get the injured to help. Step one, the injured were evacuated by use of a stretcher to the nearest clearing station. Upon arriving to the clearing station wounds were dressed, patients who were a priority were evacuated, in this step the medics would try and avoid surgery unless absolutely necessary. Step 3 included evacuating the ambulances to the nearest mobile center. After the patients were at the mobile surgery center they were assessed and if needed to be, they were taken to a hospital. The final step in De Page's triage system was to move the patients to a hospital in Paris, Versailles, Compiegne, La Panne, or another hospital near by. Because of Antonines system many lives were saved in WWI.

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After World War II many medical physicians were volunteering to go through emergency medicine training, emergency medicine was not yet a specialty, however most hospitals did not have the resources for an emergency room.  In 1946 congress passes the Hill-Burton act which gave hospitals grants to be able to efficiently equip themselves with an emergency room, nursing homes, etc.

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Attention was brought towards the needs of trauma care when the national interstate highway was developed. In 1966 the National Academy of Sciences declared traumatic injuries as a national epidemic. "The 1966 report was a turning point for trauma, the report helped spur new efforts to create regional EMS and 911 systems and establish paramedic training programs" said Dr Hoyt MD. On top of that congress helped further advance hospital care. In 1966 the Highway Safety Act created the National Highway Traffic System which also required all states to develop a EMS system. In 1973 the Emergency Medical Services System act established a grant to support regional EMS systems, air transport, and emergency medical technician (EMT) training.

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since the people of the past had such an impact on this specialty, trauma care is now a more popular specialty than it was 50 years ago. Because of the popularity many lives are saved because of paramedics arriving on scene to treat injuries from a crash/accident, and hospitals having emergency rooms where you are able to go to get medical attention as in stitches, medicine, broken bones, etc.

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Although our Trauma system in the United States is not perfect it still saves around 30,000 lives per year. We can only hope that our nation keeps advancing in the medical world so that we are able to have the resources to respond to accidents /crashes to save as many lives as we can.

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https://www.hennepinhealthcare.org/here-for-life-story/the-history-of-trauma-care/

https://pubmed.ncbi.nlm.nih.gov/10818967/

https://musculoskeletalkey.com/trauma-care-and-trauma-systems-past-present-and-future/

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"The Optimal Resources manual became the guidebook for trauma centers and trauma systems," said Ronald Stewart, MD, FACS, Chair, ACS Committee on Trauma. "It set the standards for care across pre-hospital and acute-care settings and defined the skills and equipment trauma teams and centers needed. It continues to evolve and is now used by trauma leaders in the United States, Canada, and Latin America."

In addition, in its Optimal Resources manual, ACS established the process for categorizing hospitals as Levels I, II, III or IV based on minimum standards at each level of care. In the 1980s, the ACS Verification Review Committee began conducting on-site reviews of hospitals seeking trauma designation, as well as consultations with hospitals, communities, and states that were establishing a trauma center or system. ²⁰

And it worked. Studies have shown trauma standards and verification saves lives. A 2006 study in The New England Journal of Medicine found that after adjusting for differences in injury severity, patients treated at a verified trauma center had a 25 percent lower chance of dying than patients treated at a non-trauma center. ²¹

ACS also created a series of education programs including Advanced Trauma Life Support (ATLS), which was introduced in 1980. It teaches methods for immediate management of injured patients including resuscitation and stabilization, as well as triage and transfer. Since its introduction, the course has been taken by more than one million medical providers globally. ²² Other ACS-developed courses, including Basic Endovascular Skills for Trauma (BEST), Advanced Surgical Skills for Exposure in Trauma (ASSET), Trauma Evaluation and Management (TEAM) and Advanced Trauma Operative Management (ATOM) are among the most important trauma education and training programs globally. Rural Trauma Team Development (RTTD) emphasizes a team approach to the initial evaluation and resuscitation of the trauma patient at a rural facility, and the Disaster Management and Emergency Preparedness (DMEP) teaches planning methods, preparedness, and medical management of trauma patients in mass casualty disaster situations.

The ACS Stop the Bleed course is the newest offering aimed at turning civilian bystanders into immediate responders.

Series of Reports Highlight Unfinished System

All of that work saved millions of lives, but important gaps in care remained.

"The nation's developing trauma system became a patchwork of care, with limited Federal ownership. While care was advancing quickly in some parts of the country, other areas lagged far behind. As a result, thousands of lives per year continued to be lost," said Dr. Hoyt.

A series of reports in the 1980s and 1990s reiterated the need for coordinated national attention on trauma. In 1985, the National Academy of Sciences report "Injury in America: A Continuing Health Problem," called for a greater focus on emergency care.²³ The report led to development of the Centers for Disease Control and Prevention (CDC) National Center for Injury Prevention and Control in 1992. It also spurred passage of the Trauma Care Systems Planning and Development Act in 1990 which supported development of trauma systems nationwide.²⁴ However, the programs were eliminated in 1995, leaving a gap in Federal leadership.

In 2001, the Healthcare Resources and Service Administration (HRSA) Division of Healthcare Preparedness created the Trauma/EMS Systems Program,²⁵ but it too was eliminated from the Federal budget in 2006.

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Part 1: A Brief History of Trauma Systems

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The first in a series of stories the ACS is providing on the history of trauma care reviews the history of trauma systems.

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maybe in trauma in todays world change the wording of the first two sentences to not start with because. other than that it's really good and detailed.