![]() In this article, the composition of trauma systems and the practical delivery of this care will be presented for North America. In the United States, most isolated fractures can be treated by an orthopaedic surgeon with experience in fracture care, but patients with multiple fractures, fractures associated with other system injuries, complex fractures such as pelvic, acetabular, or fractures with a significant soft tissue injury are more appropriate candidates for musculoskeletal trauma care in a higher level trauma center. Around 16,000 Canadians die every year from trauma (about 43 per day) making it the number one killer for people under 45 in this country. It is estimated that >50% of hospitalized trauma patients have one or more musculoskeletal injuries. Trauma is a very common occurrence because these countries are highly industrialized and there is a plethora of private transportation. ![]() North American trauma systems are incredibly critical for the care of injured patients yet they vary greatly across the United States and Canada. Although each trauma system has opportunities for improvement, they both provide effective access and quality care to the vast majority of injured patients. ![]() Trauma centers are classified according to their capabilities from level I (highest ability) to level IV. Population dense areas offer rapid admission to well-developed trauma centers, but injured patients in remote areas may have challenges regarding access. Both Canada and the United States utilize efficient prehospital care, and both countries recognize that postdischarge care is a financial challenge to the system. Although many states use the criteria developed by the American College of Surgeons Committee on Trauma, the individual agencies are free to utilize their own verification standards. In the United States, trauma centers are specifically verified by the individual states and thus there tends to be more variability across the country. Comparatively, the Canadian trauma system is more unified, and approximately 80% of Canadians live within 1 hour of a level I or II center. North American trauma systems are well developed yet vary widely in form across the continent.
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