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Future Shock

Donald Trunkey, MD
Arch Surg. 1992;127(6):653-658. doi:10.1001/archsurg.1992.01420060019003.
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The intent of this article is to give my vision for the future of trauma care. To do so, it is necessary to establish a very brief history of trauma systems and to describe the current status of trauma systems and trauma care.

According to Majno,1 it was the Greeks who introduced the first rudimentary trauma system. The wounded were tended to in barracks (klisiai) or in nearby ships. The Romans expanded this concept and provided special quarters called valetudinaria. Most valetudinaria were built during the first and second centuries AD, and their primary purpose was as sites at which medical care was provided to the Roman legionaries. These valetudinaria were relatively sophisticated, and there was a ready regular medical corps. At least 85 army physicians have been noted from casualty records. Paradoxically, in Rome, there were no hospitals, and civilian trauma most likely was handled by private physicians.


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