Trauma Systems


First Trauma Centre

Birmingham Accident Hospital and Rehabilitation Centre, Birmingham, UK
The Birmingham Accident Hospital opened its doors on 1st April, 1941. The first medical director was Professor William Gissane. By 1947 there were three trauma teams operating, each consisting of two consultant surgeons and a consultant anaesthetist, as well as a burn team of three consultant surgeons.

The impetus for the hospital was started by the British Medical Association's Committee on Fractures (1935) and the Interdepartmental Committee (1939) declaring that the treatment of injured persons was inadequate throughtout the British Isles. Both committees recommended that injured persons be treated in hospitals set aside for that purpose, that treatment by specially trained staff be available and that provision should be made for rehabilitation. This subsequently led to the formation of the Vernon Committee in 1939, constituting members of the medical profesison, Birmingham City Council, industry and the trade unions.

The hospital operated on three basic principles:

1. Segregation of the ill from the injured
Only trauma victims were treated at the Accident Hospital

2. Continuity of care & unity of control.
The same consultant surgeon was responsible for the patient throughout their hospital stay and throughout recovery and rehabilitation.

3. Rehabilitation is an integral part of trauma management

While the Birmingham Accident Hospital was supposed to be a model for trauma care throughout the UK, the formation of the NHS in 1948 essentially halted the development of trauma services in the UK.

The hospital finally closed it's doors in 1993.

Committee on Fractures: BMJ Suppl: 1935;1:53-62
Interdepartmental Committee: 'Final Report on the rehabilitation of persons injured by accidents.' London 1939. Her Majesty's Stationery Office.

Accidental Death and Disability. The Neglected Disease of Modern Society.
White paper from the National Academy of Sciences and National Research Council.
Accidental Death and Disability. The Neglected Disease of Modern Society. Washingto DC, Division of Medical Sciences, National Academy of Sciences, National Research Council. September 1966

First US Civilian Trauma Unit
Cook County, Chicago

Designation of Trauma Centers first established by US state law
Illinois, USA

Optimal Resources for the Care of the Seriously Injured (US)
Published by the American College of Surgeons Committee on Trauma

Injury in America - A Continuing Publc Health Problem
Published by National Academy of Sciences re-examining the paper of 1966.
Washington DC. National Academy of Sciences. 1985

Report on the Management of Patients with Major Injuries (UK)
A joint report from the Royal College of Surgeons of England and the British Orthopaedic Association highlighting the deficiencies of care in the severely injured patient throughout the United Kingdom. The findings were not dissimilar to those found in the BMA's reports of 1935 and 1939. Led to the introduction of ATLS in the UK, and three pilot trauma centres at the Royal London Hospital, the John Radcliffe Hospital in London and North-Staffordshire Hospital in Stoke. Otherwise Largely ignored.

Commission on the Provision of Surgical Services. 'Report on the Management of Patients with Major INjuries.' London, 1988. Royal College of Surgeons

Better Care forthe Severely Injured (UK)
Report from the Royal College of Surgeons Severe Injuries working group.
Almost entirely ignored.