Evacuation of trauma patients solely to level 1 centers: is the question patient or trauma center survival?

February 2006 Evacuation Time Crucial to Trauma Outcome 131Three decades have elapsed since the inception of Level I trauma centers as the finallinkinthetraumasystem“chainofsurvival.” During this period the simplistic 1960s model of the trauma system evolved into an inclusive trauma care plan for all trauma patients regardless of setting and/or severity of injury – a system encompassing prehospital care, trauma care facilities providing different levels of care, and rehabilitation services [1]. While this change does not render the Level I trauma center entirely obsolete, it has detracted from its exclusivity in treating complex trauma patients. DefinitionofthetraumacenterIt is questionable whether patient outcome can be related to the designation of the treating trauma center in light of the controversy regarding the definitionofsuchacenter.