American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

Trauma

Background

According to the Centers for Disease Control and Prevention (CDC) trauma is the leading cause of death for children and adults under age 44, killing more Americans than AIDS and stroke combined. Unfortunately, nearly 45 million Americans do not have access to a Level I or II trauma center within one hour. Ensuring access to trauma care requires many crucial components; trauma centers, physicians, and nurses must dedicate extensive resources around the clock so that seriously injured patients have the best possible chance for survival.

Federal Legislative Efforts

Prevent Bleeding Loss with Emergency Devices (BLEEDing) Act

The American College of Surgeons Committee on Trauma (ACS COT) is leading the effort to save lives by teaching the civilian population to provide vital initial response to stop uncontrolled bleeding in emergency situations. This effort is being accomplished by the development of a comprehensive and sustainable bleeding control educational and informational program targeted to civilians that will inform, educate, and empower the more than 300 million citizens of the United States. The ACS is also supportive of legislation that will assist civilians to take life-saving action when the need arises.

The Prevent Bleeding Loss with Emergency Devices (BLEEDing) Act would provide grant funding to states for bleeding control kits and training. Just like CPR training, a civilian familiar with basic bleeding control techniques is better equipped to save a life. The effort to make this training and bleeding control kits available to the public through a Department of Homeland Security grant program will help to drive the goal of reducing or eliminating preventable death from bleeding.

The ACS believes that the grant program should ensure that eligible entities are procuring only high-quality tourniquets and other bleeding control supplies, such as products approved by the Committee on Tactical Combat Casualty Care (TCCC) and Department of Defense (DoD) Combat Casualty Research Program, in order to prevent a scenario where a poorly made device might fail and not adequately stop severe bleeding.

ACS Letter of Support for Prevent BLEEDing Act to the House (5/2/2019)

ACS Letter of Support for Prevent BLEEDing Act to the Senate (2/19/2020)

Take Action: Contact Congress in Support of the Prevent BLEEDing Act

Firearm Morbidity and Mortality Prevention Efforts

Firearm injury remains a high profile topic in the national debate. The ACS COT has worked to advocate and promote a non-partisan public health approach to firearm injury prevention. This includes implementing evidence based violence prevention programs through ACS COT trauma centers and fostering a civil dialogue within professional organizations to create a consensus around reducing firearm injury and death.

The College has had numerous opportunities to share the work of the COT before Members of Congress and their staff. Including:

Before the U.S. House of Representatives Appropriations Subcommittee on Labor, Health and Human Services at a hearing, titled "Addressing the Public Health Emergency of Gun Violence."

Read Dr. Stewart’s Full Testimony

Before the U.S. House of Representatives Energy and Commerce Subcommittee on Health at a hearing titled, “A Public Health Crisis: The Gun Violence Epidemic in America."

Read Dr. Stewart’s Full Testimony

Research Funding

Federally funded research from the perspective of public health has contributed to reductions in motor vehicle crashes, smoking, and Sudden Infant Death Syndrome. The ACS believes this same approach should be applied to firearm related injuries and gun safety. The ACS has repeatedly supported funding for the CDC to conduct public health research into firearm morbidity and prevention.

Under the spending package that Congress passed on December 19th 2019, the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) each received $12.5 million to study firearm injury and prevention—the first time in more than 20 years that funding has been allocated specifically to firearm violence research. This legislative victory follows ACS grassroots efforts during the 2018 and 2019 Leadership & Advocacy Summit, as well as testimony given by Dr. Stewart before the House Appropriations Subcommittee on Labor, Health and Human Services in March 2019.

This year, the College again joined more than 100 medical, public health, and research organizations asking Congress to appropriate $50 million in funding for firearm morbidity and mortality prevention research.

Coalition Letter in Support of $50 Million for Firearm Research to the Senate

Coalition Letter in Support of $50 Million for Firearm Research to the House

Bipartisan Background Checks Act of 2019

In 2018, the ACS COT released a set of 13 recommendations from its Firearm Strategy Team (FAST) Workgroup. These proposals include strategies and tactics to reduce firearm injury, death, and disability in the United States. One of these recommendations includes support for a robust and accurate background check for all firearm purchases and transfers.

H.R. 8, the Bipartisan Background Check Act of 2019, is legislation that would require all firearm sales to go through the National Instant Background Check System (NICS) as established under the Brady Handgun and Violence Prevent Act. The ACS believes this legislation is a key step in addressing the public health crisis.

ACS Letter of Support for H.R. 8, the Bipartisan Background Checks Act

Take Action: Contact Congress in Support of the Bipartisan Background Checks Act of 2019

Bipartisan Solution to Cyclical Violence Act

Trauma centers stand on the front lines of the interpersonal violence epidemic. With injury recidivism rates as high as 55 percent, trauma surgeons and other advocates are exploring ways to close this revolving door to decrease violent injury, similar to the methods that have been used effectively to reduce the incidence of cardiovascular disease and cancer.

Hospital-based Violence Intervention Programs (HVIPs) are multidisciplinary programs that identify patients at risk of repeat violent injury and link them with hospital- and community-based resources aimed to address underlying risk factors for violence, such as mental health and social determinants of health. Data indicate the HVIPs reduce violent injury recidivism, as well as hospital costs, but more research is needed in order to better target these efforts and help spread them to areas of need around the country.

H.R. 5855, the Bipartisan Solution to Cyclical Violence Act of 2020, would provide grant funding to create new HVIP programs as well as expand current successful programs. It also requires research on best practices which will play a critical role in documenting the success of these programs and will create a road map for hospitals to follow.

ACS Letter of Support for the Bipartisan Solution to Cyclical Violence Act

Take Action: Contact Congress in Support of the Bipartisan Solution to Cyclical Violence Act

Mission Zero Act

MISSION ZERO builds on the recommendations of the 2016 National Academies of Science, Engineering, and Medicine (NASEM) report titled, “A National Trauma Care System: Integrating Military and Civilian Trauma Systems to Achieve Zero Preventable Deaths After Injury” to creates a U.S. Department of Health and Human Services (HHS) grant program to cover the administrative costs of embedding military trauma professionals in civilian trauma centers. These military-civilian trauma care partnerships will allow military trauma care teams and providers to gain exposure to treating critically injured patients and increase readiness for when these units are deployed. Additionally, best practices from the battlefield are brought home to further advance trauma care and provide greater civilian access.

The MISSION ZERO Act was signed into law on June 24, 2019, as part of S. 1279, the Pandemic and All Hazards Preparedness and Advancing Innovation (PAHPAI) Act. (Public Law No:116-22)

ACS encourages Congress to fully fund MISSION ZERO at the authorized amount of $11.5 million as part of the Fiscal Year (FY) 2021 Labor, Health and Human Services, Education, and Related Agencies (LHHS) Appropriations package.

MISSION ZERO Overview

Trauma Coalition Letter of Support for MISSION ZERO in the House

Trauma Coalition Letter of Support for MISSION ZERO in the Senate

Senate MISSION ZERO Appropriations Request

House MISSION ZERO Appropriations Request

Take Action: Contact Congress in Support of MISSION ZERO funding