Trauma system: the backbone of disaster preparedness.
BACKGROUND
To describe the Los Angeles County trauma system response to disasters.


METHODS
Review of trauma system structure and multicasualty events.


RESULTS
The Los Angeles County trauma system is made up of 13 level I and II trauma centers with defined catchment areas that serve 10 million people in 88 cites over 4,000 square miles and receive more than 20,000 trauma activations annually. There is an organized disaster plan, which is orchestrated through the Medical Alert Center that coordinates the distribution of casualties from the scene of a multicasualty event, with the most critically injured patients going to level I centers by air, severe injuries to level I and II centers by ground and air and less severe injuries to local community hospitals by ground. The plan has been used in several multicasualty events over the last 25 years, the most recent of which occurred 6 hours after this paper was presented.


CONCLUSIONS
The system allows for all critically injured patients to be distributed to several trauma centers, so that all can be cared for in a timely fashion without overwhelming any one trauma center and without critically injured patients being taken to nontrauma centers where they cannot receive optimal care. The answer to disaster preparedness in our country is to develop this kind of trauma system in every state. Doing so will improve access of our population to excellent care on a daily basis and will provide a network of trauma centers that can be mobilized to most effectively care for victims of multicasualty events.
Cryer
H Gill
HG
Department of Surgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095, USA. hcryer@mednet.ucla.edu
Hiatt
Jonathan R
JR
D004189:Disaster Planning / Q000458:organization & administration*; D004632:Emergency Medical Services / Q000458:organization & administration*; D006752:Hospital Planning / Q000458:organization & administration*; D006801:Humans; D015141:Los Angeles / Q000453:epidemiology; D054527:Mass Casualty Incidents / Q000401:mortality*; D015397:Program Evaluation; D012041:Regional Medical Programs / Q000458:organization & administration*