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
Slide 2
The Injury Pyramid Mild Moderate Severe Fatal Severity of
Injury Number of Patients
Slide 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
Slide 4
Slide 5
Slide 6
Trimodal mortality distribution
Slide 7
You are 25% more likely to live if you are treated at a Trauma
Center
Slide 8
NTDB Annual Report 2010 American College of Surgeons 2010. All
Rights Reserved Worldwide National Trauma Data Bank 2010 Annual
Report
Slide 9
Slide 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.
Slide 11
Slide 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!
Slide 13
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
Slide 14
Key Infrastructure Elements Leadership at the state &
regional level Professional Resources Education and Advocacy
Information Management Finances Research Technology Disaster
Preparedness and Response
Slide 15
Slide 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.
Slide 17
Slide 18
Slide 19
Slide 20
Slide 21
Thank You
Slide 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
Slide 23
Fundamental Components of the Trauma Care System Injury
Prevention Prehospital Care Acute Care Facilities Post-hospital
Care
Slide 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