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The role of public health in achieving the toward zero deaths - TZD goals AASHTO Safety Leadership Forum V The Paris Hotel, Las Vegas, NV May 5, 2011 John Fildes, MD, FACS, FCCM Medical Director of Trauma Programs American College of Surgeons Committee on Trauma Professor & Vice Chair of Surgery Program Director of Surgery, Critical Care, & Acute Care Surgery Chief, Trauma & Critical Care Univ. of Nevada School of Medicine Medical Director of the Trauma Center Univ. Medical Center of Southern NV

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The Injury Pyramid Mild Moderate Severe Fatal Severity of Injury Number of Patients

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Injury facts Injury is the leading cause of death 0-44 Half of all injury deaths occur before medical intervention For every 1 death there are: 3 permanent disabilities 75 temporary disabilities Injury deaths cause the loss of more years of productive life than cancer & heart disease combined Injury care is the most expensive medical care

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Trimodal mortality distribution

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You are 25% more likely to live if you are treated at a Trauma Center

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NTDB Annual Report 2010 American College of Surgeons 2010. All Rights Reserved Worldwide National Trauma Data Bank 2010 Annual Report

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Maull KI. Dispelling fatalism in a cause-and-effect world: 1989 Eastern Association for the Surgery of Trauma presidential address. J Trauma. 1989; 29: 752-756.

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TZD, the nexus with health care Engineering Education Enforcement Emergency health care: Access to care Pre-hospital care Hospital care Organized into a Trauma System!

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TZD, the nexus with health care Health Care supports: All the Es The strategic safety planning efforts Trauma Systems: Save lives Spans from education & prevention to rehab & outcomes informatics Driven by performance improvement

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Key Infrastructure Elements Leadership at the state & regional level Professional Resources Education and Advocacy Information Management Finances Research Technology Disaster Preparedness and Response

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Center for Traffic Safety Research Nevada Crash Data Nevada Medical Data In 2009 Nevada Motor Vehicle Crash records and UMC Trauma registry data were linked to create a unique database that includes crash scene data, EMS and hospital information. The Center for Traffic Safety Research is working to demonstrate the link between prevention and outcomes.

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Thank You

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Injury facts Injury is the leading cause of death 0-44 Half of all injury deaths occur before medical intervention For every 1 death there are: 3 permanent disabilities 75 temporary disabilities Injury deaths cause the loss of more years of productive life than cancer & heart disease combined Injury care is the most expensive medical care

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Fundamental Components of the Trauma Care System Injury Prevention Prehospital Care Acute Care Facilities Post-hospital Care

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Leading cause of death, Traffic Research Center, Health care nexus, costs, Chief Health Official in each state should be involved Health community role in zero deaths/fatality Strategic safety planning efforts Education, prevention, cost reduction

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The Goal of the Trauma System: