What is TREF?
- TREF is a non-profit organization incorporated in 1983 to represent San Diego’s Trauma Care System.
- Members are physicians, nurses, and community volunteers who are passionate about injury prevention and advancing trauma care throughout our community.
- Provides safety education programs to the public about trauma as a disease and trauma prevention.
- Coordinates professional education programs for trauma clinicians to improve quality of care.
- Provides subject matter experts for trauma presentations to public and professional groups.
- Supports trauma research and evidence-based practice through grant-funding of scientific research in the care and treatment of trauma victims.
San Diego County Trauma System celebrated 30 years of coordinated trauma care in 2014.
- Prior to 1984, any injured patient was taken to the closest Basic Emergency Care Center.
- An audit of injury-related deaths by the Amherst Consulting Group in 1982-83, prior to the initiation of a formal trauma system in San Diego County
- 13.6% Frankly Preventable deaths
- 7.9% Potentially Preventable deaths
It was clear that if patients had been evaluated and treated by trauma clinicians in a timely manner, their chances at survival would have greatly increased.
- August 1984, six Trauma Centers were designated (CA State designates Trauma Centers through the local EMS agency – contract compliance reviewed annually)
- Palomar Medical Center (1985)
- Rady Children’s Hospital San Diego (Regional Pediatric Center)
- Scripps Memorial Hospital –La Jolla
- Scripps Mercy Hospital
- Sharp Memorial Hospital
- UC San Diego Health System (Regional Burn Center)
- County EMS agencies began delivering major trauma victims to the trauma centers.
- Adult patients meeting “Trauma Triage Criteria” are taken to the Adult Trauma Center based on where they are injured in the County – Catchment Map.Catchment Map
- All Pediatric patients (≤ 14 years old) are taken to the Regional Pediatric Trauma Center (Rady Children’s Hospital San Diego).
- Major burn patients (adult and pediatric) are taken to UCSD Regional Burn Center.
- All EMS pre-notified trauma patients are evaluated and treated for life-threatening injuries by a dedicated trauma team on arrival, led by a Trauma Surgeon.
- Adult patients meeting “Trauma Triage Criteria” are taken to the Adult Trauma Center based on where they are injured in the County – Catchment Map
- Trauma Centers are also verified by the American College of Surgeons (ACS) with an on-site review every 3 years to ensure resources, personnel, leadership, and administrative commitment to provide optimal care of trauma patients
Benefit of Trauma Systems
- Designated trauma hospitals
- Increase survival by 25%
- Have all the components for care 24/7
- Trauma systems
- Coordinate care across continuum from pre-hospital / resuscitation / to rehabilitation
- Provide disaster and surge planning
- San Diego is a great example
- Preventable deaths before 1984 > 20%
- Preventable deaths after 1984 < 1-2%