calls for eliminating all preventable trauma-related
deaths in both military and civilian trauma patients.
The leadership of the ACS Committee on Trauma
(COT) is grateful for the contributions of the
National Academies and our dedicated Fellows of the
College, specifically those who produced both the
original white paper and this latest comprehensive
report. In the tradition of the original contributors
from 50 years ago, six Fellows of the College served
on the most recent committee (all MD, FACS): Adil
Haider; John B. Holcomb; Cato T. Laurencin; the
late Norman E. McSwain, Jr.; Thomas M. Scalea;
and C. William Schwab. The Academies dedicated
the report to Dr. McSwain, who died during production of the current report.
This latest document outlines important opportunities for strengthening the relationship between
the ACS and the U.S. military. Moreover, the efforts
of the Academies committee provide a roadmap for
improving the trauma care of U.S. citizens and of our
troops in times of war.
This article outlines the events leading up to the
release of the report, summarizes its 11 recommendations, and describes how the ACS and other trauma
leaders have collaborated to promote optimal care of
the injured patient and to advance the agenda established by the NASEM.
Events leading up to the report
Dr. Schwab set the stage for developing A National
Trauma Care System: Integrating Military and Civilian
Trauma Systems to Achieve Zero Preventable Deaths after
Injury in the Scudder Oration, which he delivered at
the ACS Clinical Congress 2014. In his presentation,
Dr. Schwab called for the establishment of “…a think
tank of senior civilian consultants to take on the
larger and more difficult issues for the readiness and
surgical mission of the Defense Health Authority and
the Department of Defense.” He went on to state
that “these subject content experts should be struc-
tured to assure relevance, impact, and value. This
think tank should be composed of the best thinkers
in academic surgery and medicine, health adminis-
tration, finance, and economics.” 4
In line with this vision, other key sponsors of the
NASEM report included the American College of
Emergency Physicians, the National Association of
EMS Physicians, the National Association of Emergency Medical Technicians, the Trauma Center
Association of America, the U.S. Department of
Defense, the U.S. Department of Homeland Security, and the U.S. Department of Transportation.
Although sponsored by the ACS and these other
leading organizations, one of the strengths of the
Academies’ report is that the recommendations were
derived independently from a group of experts convened by NASEM.
Donald Berwick, MD, chair of the NASEM
Committee on Military Trauma Care’s Learning
Health System and Its Translation to the Civilian
Sector, noted, “Both the military and civilian sectors have made impressive progress and important
innovations in trauma care, but there are serious
limitations in the diffusion of those gains from location to location…the successes have saved many
lives; the disparities have cost many lives. With the
decrease in combat and the need to maintain readiness for trauma care between wars, a window of
opportunity now exists to integrate military and
civilian trauma systems and view them not separately, but as one.” 5
A report sponsored by the ACS, the U.S.
Department of Defense, and other leading
health care organizations calls for eliminating
all preventable trauma-related deaths in
both military and civilian trauma patients.