1. 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

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

3. 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

6. Trimodal mortality distribution

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

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

10. 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.

12. 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!

13. TZD, the nexus with health care… Health Care supports:  All the ‘E’s  The strategic safety planning efforts Trauma Systems:  Save lives  Spans from education & prevention to rehab & outcomes informatics  Driven by performance improvement

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

16. 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.

21. Thank You

22. 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

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

24. 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

25. The Goal of the Trauma System: