What is trauma?
One out of every three people will be either directly or indirectly affected by trauma. A trauma is any life-threatening occurrence, either accidental or intentional, that causes injuries. The leading causes of trauma are motor vehicle accidents, falls, and assaults. Trauma is the leading cause of death among Americans under 44 years of age. It is a fact that a trauma occurs every four seconds. Six minutes from now, someone in the United States will die from trauma and another will be permanently disabled. Trauma kills more people under the age of 44 than cancer, heart disease, AIDS or other diseases. It kills or disables people during their most productive years of life, and costs the U.S. public over $133 billion annually in direct and indirect cost to society. Fortunately, since the inception of the San Diego County Trauma System in 1984, the preventable death rate from major traumatic injury in this county fell from 21% to less than 1%. Motor vehicle accidents account for nearly 75% of the traumatic injuries in San Diego County, and over half of those who die are not wearing seat belts.
About the UC San Diego Regional Trauma Center
In 1984 the UC San Diego Trauma Center joined with six other area hospitals to form what we now know is the finest trauma system in the country. The San Diego County Trauma System consists of 6 trauma centers and 3 pre-hospital providers. Each trauma center provides trauma care to the designated catchment area.
On September 18, 2004, all six trauma centers and the County of San Diego celebrated our 20th anniversary of the San Diego Trauma System. The highlights for that night consist of a story of seven patients who described their experiences as trauma patients, and the guest of honor Vice Admiral Richard H. Carmona, MD, MPH, FACS, the United States Surgeon General who praised our San Diego County Trauma System as one of the best in the country.
The UC San Diego Trauma Center is the smallest catchment area but the densest in population. The borders of our catchment area follow the lines from south 805 to the ocean and highway 8 to the Mexican border. Imperial County has no trauma system.
Patients are brought here to the resuscitation suite and not the Emergency Department as a major trauma victim based on a decision by pre-hospital paramedics in conjunction with the radio bay station nurses and the doctors. Triage criteria for transport of a major trauma victim to the resuscitation suite include physiologic criteria, for example; low blood pressure, decreased Glasgow coma score, or a high respiratory rate. Or, anatomic criteria for major trauma which would include penetrating wounds to the torso, amputations, and major facial injuries with airway in jeopardy. These are the so-called hard criteria. Soft criteria, on the other hand would include brief loss of consciousness or a mechanism of injury with a high index of suspicion for injury. For example; frontal crashes at high speed, death of another car occupant, pedestrian versus auto, or a driver of a small car T-boned by an SUV. We receive patients in a variety of ways; by ground ambulance with paramedics or basic-skilled EMTs, by helicopter or by walk-in or drop off by the sheriff or the police. Many of our patients are transferred to us from Imperial County which has no trauma system and has only limited physician specialty coverage. We usually receive patients from El Centro Medical Center, Pioneer Hospital in Brawley or Yuma Medical Center. Since then, the mortality rate had been reduced dramatically.
Our trauma center admits approximately 3,200 patients a year who are Trauma Team Activations. Patients who have been identified by emergency services in the pre-hospital system to be at higher risk for serious multi-system injuries, are brought directly to the resuscitation suite or trauma operating room. For example; people who have sustained severe injuries often involving several areas of the body (such as a brain concussion, internal bleeding, and broken bones) are admitted to the UCSD Trauma Center. Many patients have other medical problems complicated by trauma. In some instances, patients are transferred from other hospitals to take advantage of the special facilities and highly trained personnel available at the UCSD Trauma Center. In 2018, UC San Diego Trauma Center received Level I reverification from the American College of Surgeons’ Committee.
By providing truly comprehensive care for trauma patients – from intensive care through intermediate care, acute care and rehabilitation – the UC San Diego Trauma Center remains committed to decreasing the mortality rate from traumatic injuries in the San Diego Region.