The Northern Nevada Orthopaedic Trauma System was designed and introduced into clinical practice in Reno, Nevada, in 1994. This unique trauma system was first reported in this journal in 2001, in an article presenting the first seven years of the experience1. That report outlined the guidelines for the design, development, implementation, and maintenance of a previously undescribed private-practice orthopaedic trauma panel in a community or rural level-II trauma system. Today, this orthopaedic trauma panel continues to function as an integral part of the Renown Health System (previously Washoe Health System) in Reno, Nevada. This model has served as an example of one type of experience for other interested, developing programs. The program has recently passed the recertification process set forth by the American College of Surgeons Committee on Trauma. In the current update, we review the progress of the program during the past six years as it relates to the mounting pressures on the nation's emergency-department call systems, the program's growth and development opportunities, as well as the newer personnel changes implemented to accommodate the stresses on the hospital-based trauma system in the Northern Nevada referral area.
Mounting Emergency-Department Pressures
It has been well established by the authors of a recent study that this nation continues to confront a crisis in its ability to provide orthopaedic care for the trauma patient2. In 2006, the Trauma Care and On-Call Project Team of the American Academy of Orthopaedic Surgeons (AAOS) cited multiple factors driving this problem, including the increasing number of patients seeking emergency-department care, the reduced number of hospital emergency departments, inadequate funding, and a decreasing number of specialists willing to take call3. Not only does trauma now account for >11% of hospital admissions, but it has become the most expensive category of medical treatment. Emergency-department physicians are …
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