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

Each year, more than 180,000 people die from traumatic injuries sustained as a result of events including vehicle crashes, falls, industrial and farm accidents, shootings, and natural disasters. The most common preventable cause of these deaths is hemorrhage in the minutes before trained first responders arrive.

The ACS Committee on Trauma (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. ACS is also supportive of legislation that will assist civilians to take life-saving action when the need arises.

H.R. 2550 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.

Last year in June, Fellows of the American College of Surgeons instructed more than 75 Congressional staff during a Stop the Bleed Training session hosted by Congressman Mike Thompson (D-CA) through the Gun Violence Prevention Task Force. This legislation is a direct result of that event, continued educational efforts by the college, and the interest of members of Congress. Read the press release on that training.

ACS Letter of Support for the Prevent Bleeding Act

Take Action: Contact Congress in Support of the Prevent Bleeding Loss with Emergency Devices (BLEEDing) Act

Firearm Morbidity and Mortality Prevention Efforts

Firearm injury remains a high profile topic in the national debate. The ACS Committee on Trauma (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

This year, the College joined more than 100 medical, public health, and research organizations asking Congress to appropriate $50 million in funding for this type of research.

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.

This year, the College 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. Following this letter and ACS testimony before the Appropriations Subcommittee, the House passed H.R. 2740, the Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act. This legislation passed on June 19 with a vote of 226–203 and included ACS-supported language providing $50 million for firearm morbidity and mortality prevention research.

ACS Letters of Support for $50 Million in Funding for Firearm Research

Bipartisan Background Checks Act of 2019

In 2018, the American College of Surgeons Committee on Trauma (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

End the Cycle of 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. 2464, the End the Cycle of Violence Act of 2019, would provide grant funding to HVIPs to conduct research on best practices. The ACS believes this research 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 End the Cycle of Violence Act

Mission Zero Act

The ACS strongly supports the Mission Zero Act, legislation that would create a grant program to assist civilian trauma centers in partnering with military trauma professionals to establish a pathway to provide patients with the highest quality of trauma care in times of peace and war. This is accomplished with the following:

  • Providing grant funding for military trauma teams/providers to embed in civilian trauma facilities
  • Trauma centers are eligible for a $1 million grant to host military trauma teams at eligible high-acuity level 1 trauma centers
  • Trauma centers are also eligible for grants to host individual providers ($100,000 for physician or $50,000 for non-physician providers) at eligible level 1, 2, or 3 trauma centers

ACS Letter of Support for the Mission Zero Act

Legislative Success

Pandemic and All-Hazards Preparedness and Advancing Innovations Act

In June 2019, Congress passed S. 1379, The Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2019. Included in this package are ACS-supported trauma initiatives, including the Mission Zero Act. 

The Pandemic and All-Hazards Preparedness Act (PAHPA) was created to improve the nation’s response to public health and medical emergencies. PAHPA also has a great level of oversight authority over implementation and recommendations within the June 2016 National Academies of Sciences, Engineering, and Medicine (NASEM) report on trauma care, A National Trauma Care System: Integrating Military and Civilian Trauma Systems to Achieve Zero Preventable Deaths After Injury.  

The Mission Zero Act would create a grant program to assist civilian trauma centers in partnering with military trauma professionals to establish a pathway to provide patients with the highest quality of trauma care in times of peace and war. 

This legislation now heads to the President’s desk to be signed into law.

Pandemic and All-Hazards Preparedness Act Overview

ACS Letter of Support for the Pandemic and All Hazards Preparedness and Innovations Act