2017 Volume 31 Issue 2 Pages 79-86
We introduce the process of establishment and present status of the first local government-directed major trauma center in our country in the City of Yokohama. First, the retrospective population based study revealed the number of preventable trauma deaths in the city. We focused on hemorrhagic shock with torso injury as the main target to treat at the trauma center. The city designated two major trauma centers and added the function of "trauma care for serious injury" to 2 of 8 existing tertiary emergency and critical care centers. Yokohama City Medical Control Council introduced a prehospital medical protocol. The two centers replaced their hybrid operating room and resuscitation room with a CT scan, respectively. The unexpected trauma survivor rate increased after the establishment in the single center study. Regional trauma care systems should aim to save lives and function to reduce post-trauma disabilities. In the future, the definition of "trauma center" should be clarified, and further effort will be necessary for the nationwide establishment of an inclusive trauma care system based on local emergency medical service plans with continuous quality improvement to avoid preventable death as well as disabilities.
