About Us

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 .
    • 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.
  • 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%