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• W1991831572 abstract "Spinal cord injury is a multibillion dollar annual health care problem in the United States and across the world. It is considered a catastrophic disease because of the high morbidity, mortality and economic impact associated with these paralysing injuries. We advocate a systems approach for the comprehensive management of spinal cord injury patients based on an extensive multicentre experience which has produced data supporting this concept. The front end of this system involves prevention programmes based on the philosophy that it is more sensible to avoid an injury or disease than to have to deal with its treatment and con­ sequences, especially when therapy is so complex as it is in the case of spinal cord injuries. This phase involves public and professional education through various media modalities as well as legislative action directed towards safety equipment, speed limits, handgun restrictions, etc. Although successful in some areas, to date these prevention programmes have not affected the overall numbers of spinal cord injuries in our country or abroad. The next phase of system care involves the front end of the medical delivery component or the pre­ hospital management phase. Modern emergency medical services in the United States evolved as a result of the classic white paper, Accidental Death and Dis­ abilities-The Neglected Disease of Modern Society, released by the National Academy of Sciences National Research Council Committee on Shock and the Committee on Trauma, 1966. This document drew attention to the severe deficiencies existing in emergency care and served as a catalyst for a series of events directed towards improvement in the care of trauma victims. The Emergency Medical Services Systems which evolved were comprised of 15 components identified by Congress and the Emergency Medical Services Systems Act which also defined seven critical patient groups for emphasis, one of which was Spinal Cord Injuries. In 1984, there were 92 000 accidental deaths in the United States with about 50° [) being caused by auto accidents with an economic impact estim ated to be 96·9 billion dollars in lost wages and 13·8 billion dollars in medical expenses. In spite of these overwhelming figures and the significant successes of the National Emergency Medical Service programme, federal funding was eliminated as part of the budget trimming process in the" @default.
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• W1991831572 date "1987-06-01" @default.
• W1991831572 modified "2023-09-27" @default.
• W1991831572 title "Pre-hospital management of spinal cord injuries" @default.
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• W1991831572 doi "https://doi.org/10.1038/sc.1987.41" @default.
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