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History

Injury related research conducted following the Viet Nam war demonstrated that the civilian application of principles learned from the military management of trauma can significantly reduce injury related morbidity and mortality. Concentrating trauma care in specialized facilities where multiple, coordinated services are immediately available is essential to achieving optimal outcomes for these patients. Without an organized, consistent approach to the trauma patient, the resources necessary to assess and treat the injury victim will be absent or slow to respond, making diagnosis and treatment haphazard, uncoordinated, and at times ineffective.

A systematic approach to trauma care provides the best means to protect the public from premature death and prolonged disability. A trauma care system reduces death and disability by identifying the causes of injury and promoting activities to prevent injury from occurring, and assuring that the required emergency medical resources are available, and the necessary infrastructure in place, to deliver the "right" patient to the "right" hospital.

In 1982, Daniel K. Lowe, MD and his colleagues conducted a non-autopsy, retrospective analysis of 762 severely injured patients admitted to 23 hospitals in a six county area, including Portland, and the surrounding rural areas. The patients had been taken to the nearest hospital to where the injury occurred, without regard to their special capabilities. Hospitals then had not been designated or categorized as trauma centers. Twenty-five percent of the fatalities and 16% of all outcomes were considered "inappropriate" for the severity of injury incurred. Furthermore, they demonstrated that the average time required for a surgeon to respond and attend to an injured patient was greater than one hour.

In 1983, Senate Joint Resolution 23, introduced by Senator Starkovitch and then-Senator John Kitzhaber, authorized the Oregon Health Services (OHS) to develop a plan for a statewide trauma system.

In 1984, the Oregon Trauma Plan, which included standards and pre-established protocols for prehospital trauma care, trauma center triage, trauma center designation, system-wide quality assurance, research, and injury prevention was completed.

In 1985, the Oregon Legislature passed Senate Bill 147, which provided the authority for the creation of a statewide trauma system. In September of 1985, Governor Victor Atiyeh signed this Bill, making Oregon one of the few states in the nation to approach trauma care in a systematic manner. The original legislation has been amended over the years, and is presently codified as Oregon Revised Statutes (ORS) 431.607 et seq. The implementing regulations, first promulgated by the Health Services on September 20, 1985 are set forth as Oregon Administrative Rules (OAR) Chapter 333, Division 200.

Oregon is recognized throughout the nation as a leader in trauma systems development. The second state to develop any sort of statewide trauma system whatsoever (Maryland is recognized as the first), Oregon was the first state to develop a system which included small rural hospitals as well as large urban facilities; which was voluntarily entered into by hospitals; and which utilizes volunteer regional boards to plan, implement, and monitor system activities.