Trauma Centers: Specialized hospital facilities which provide diagnostic and therapeutic services for trauma patients.Injury Severity Score: An anatomic severity scale based on the Abbreviated Injury Scale (AIS) and developed specifically to score multiple traumatic injuries. It has been used as a predictor of mortality.Wounds and Injuries: Damage inflicted on the body as the direct or indirect result of an external force, with or without disruption of structural continuity.Trauma Severity Indices: Systems for assessing, classifying, and coding injuries. These systems are used in medical records, surveillance systems, and state and national registries to aid in the collection and reporting of trauma.Wounds, Nonpenetrating: Injuries caused by impact with a blunt object where there is no penetration of the skin.Multiple Trauma: Multiple physical insults or injuries occurring simultaneously.Wounds, Penetrating: Wounds caused by objects penetrating the skin.Air Ambulances: Fixed-wing aircraft or helicopters equipped for air transport of patients.Abdominal Injuries: General or unspecified injuries involving organs in the abdominal cavity.Triage: The sorting out and classification of patients or casualties to determine priority of need and proper place of treatment.Craniocerebral Trauma: Traumatic injuries involving the cranium and intracranial structures (i.e., BRAIN; CRANIAL NERVES; MENINGES; and other structures). Injuries may be classified by whether or not the skull is penetrated (i.e., penetrating vs. nonpenetrating) or whether there is an associated hemorrhage.Accidents, Traffic: Accidents on streets, roads, and highways involving drivers, passengers, pedestrians, or vehicles. Traffic accidents refer to AUTOMOBILES (passenger cars, buses, and trucks), BICYCLING, and MOTORCYCLES but not OFF-ROAD MOTOR VEHICLES; RAILROADS nor snowmobiles.Wounds, Gunshot: Disruption of structural continuity of the body as a result of the discharge of firearms.Retrospective Studies: Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons.Neck Injuries: General or unspecified injuries to the neck. It includes injuries to the skin, muscles, and other soft tissues of the neck.Thoracic Injuries: General or unspecified injuries to the chest area.Vascular System Injuries: Injuries to blood vessels caused by laceration, contusion, puncture, or crush and other types of injuries. Symptoms vary by site and mode of injuries and may include bleeding, bruising, swelling, pain, and numbness. It does not include injuries secondary to pathologic function or diseases such as ATHEROSCLEROSIS.Traumatology: The medical specialty which deals with WOUNDS and INJURIES as well as resulting disability and disorders from physical traumas.Wounds, Stab: Penetrating wounds caused by a pointed object.Transportation of Patients: Conveying ill or injured individuals from one place to another.Emergency Medical Services: Services specifically designed, staffed, and equipped for the emergency care of patients.Abbreviated Injury Scale: Classification system for assessing impact injury severity developed and published by the American Association for Automotive Medicine. It is the system of choice for coding single injuries and is the foundation for methods assessing multiple injuries or for assessing cumulative effects of more than one injury. These include Maximum AIS (MAIS), Injury Severity Score (ISS), and Probability of Death Score (PODS).Mass Casualty Incidents: Events that overwhelm the resources of local HOSPITALS and health care providers. They are likely to impose a sustained demand for HEALTH SERVICES rather than the short, intense peak customary with smaller scale disasters.Glasgow Coma Scale: A scale that assesses the response to stimuli in patients with craniocerebral injuries. The parameters are eye opening, motor response, and verbal response.Patient Transfer: Interfacility or intrahospital transfer of patients. Intrahospital transfer is usually to obtain a specific kind of care and interfacility transfer is usually for economic reasons as well as for the type of care provided.Catchment Area (Health): A geographic area defined and served by a health program or institution.Patient Admission: The process of accepting patients. The concept includes patients accepted for medical and nursing care in a hospital or other health care institution.Facial Injuries: General or unspecified injuries to the soft tissue or bony portions of the face.Leg Injuries: General or unspecified injuries involving the leg.Emergency Service, Hospital: Hospital department responsible for the administration and provision of immediate medical or surgical care to the emergency patient.Resuscitation: The restoration to life or consciousness of one apparently dead. (Dorland, 27th ed)Brain Injuries: Acute and chronic (see also BRAIN INJURIES, CHRONIC) injuries to the brain, including the cerebral hemispheres, CEREBELLUM, and BRAIN STEM. Clinical manifestations depend on the nature of injury. Diffuse trauma to the brain is frequently associated with DIFFUSE AXONAL INJURY or COMA, POST-TRAUMATIC. Localized injuries may be associated with NEUROBEHAVIORAL MANIFESTATIONS; HEMIPARESIS, or other focal neurologic deficits.Hospitals, Rural: Hospitals located in a rural area.Snow Sports: Sports activities in the snow.Health Facility Closure: The closing of any health facility, e.g., health centers, residential facilities, and hospitals.Fracture Fixation: The use of metallic devices inserted into or through bone to hold a fracture in a set position and alignment while it heals.Prospective Studies: Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.Hospitals, Urban: Hospitals located in metropolitan areas.Length of Stay: The period of confinement of a patient to a hospital or other health facility.Treatment Outcome: Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.Fractures, Bone: Breaks in bones.Spinal Injuries: Injuries involving the vertebral column.United StatesAmbulances: A vehicle equipped for transporting patients in need of emergency care.Terrorism: The use or threatened use of force or violence against persons or property in violation of criminal laws for purposes of intimidation, coercion, or ransom, in support of political or social objectives.Pelvic Bones: Bones that constitute each half of the pelvic girdle in VERTEBRATES, formed by fusion of the ILIUM; ISCHIUM; and PUBIC BONE.Time Factors: Elements of limited time intervals, contributing to particular results or situations.Emergency Medicine: The branch of medicine concerned with the evaluation and initial treatment of urgent and emergent medical problems, such as those caused by accidents, trauma, sudden illness, poisoning, or disasters. Emergency medical care can be provided at the hospital or at sites outside the medical facility.Stress Disorders, Post-Traumatic: A class of traumatic stress disorders with symptoms that last more than one month. There are various forms of post-traumatic stress disorder, depending on the time of onset and the duration of these stress symptoms. In the acute form, the duration of the symptoms is between 1 to 3 months. In the chronic form, symptoms last more than 3 months. With delayed onset, symptoms develop more than 6 months after the traumatic event.Hospital Mortality: A vital statistic measuring or recording the rate of death from any cause in hospitalized populations.IsraelThoracostomy: Surgical procedure involving the creation of an opening (stoma) into the chest cavity for drainage; used in the treatment of PLEURAL EFFUSION; PNEUMOTHORAX; HEMOTHORAX; and EMPYEMA.Registries: The systems and processes involved in the establishment, support, management, and operation of registers, e.g., disease registers.Regional Medical Programs: Coordination of activities and programs among health care institutions within defined geographic areas for the purpose of improving delivery and quality of medical care to the patients. These programs are mandated under U.S. Public Law 89-239.Fracture Fixation, Internal: The use of internal devices (metal plates, nails, rods, etc.) to hold the position of a fracture in proper alignment.Psychotherapy, Brief: Any form of psychotherapy designed to produce therapeutic change within a minimal amount of time, generally not more than 20 sessions.Germinal Center: The activated center of a lymphoid follicle in secondary lymphoid tissue where B-LYMPHOCYTES are stimulated by antigens and helper T cells (T-LYMPHOCYTES, HELPER-INDUCER) are stimulated to generate memory cells.Shock, Traumatic: Shock produced as a result of trauma.Orthopedics: A surgical specialty which utilizes medical, surgical, and physical methods to treat and correct deformities, diseases, and injuries to the skeletal system, its articulations, and associated structures.Accidental Falls: Falls due to slipping or tripping which may result in injury.Outcome and Process Assessment (Health Care): Evaluation procedures that focus on both the outcome or status (OUTCOMES ASSESSMENT) of the patient at the end of an episode of care - presence of symptoms, level of activity, and mortality; and the process (ASSESSMENT, PROCESS) - what is done for the patient diagnostically and therapeutically.WashingtonPhysician Executives: Physicians who serve in a medical and administrative capacity as head of an organized medical staff and who also may serve as liaison for the medical staff with the administration and governing board.Emergency Treatment: First aid or other immediate intervention for accidents or medical conditions requiring immediate care and treatment before definitive medical and surgical management can be procured.Multiple Organ Failure: A progressive condition usually characterized by combined failure of several organs such as the lungs, liver, kidney, along with some clotting mechanisms, usually postinjury or postoperative.Benchmarking: Method of measuring performance against established standards of best practice.Tibial FracturesChild Day Care Centers: Facilities which provide care for pre-school and school-age children.Blood Coagulation Disorders: Hemorrhagic and thrombotic disorders that occur as a consequence of abnormalities in blood coagulation due to a variety of factors such as COAGULATION PROTEIN DISORDERS; BLOOD PLATELET DISORDERS; BLOOD PROTEIN DISORDERS or nutritional conditions.Blood Transfusion: The introduction of whole blood or blood component directly into the blood stream. (Dorland, 27th ed)Blood Component Transfusion: The transfer of blood components such as erythrocytes, leukocytes, platelets, and plasma from a donor to a recipient or back to the donor. This process differs from the procedures undertaken in PLASMAPHERESIS and types of CYTAPHERESIS; (PLATELETPHERESIS and LEUKAPHERESIS) where, following the removal of plasma or the specific cell components, the remainder is transfused back to the donor.Risk Factors: An aspect of personal behavior or lifestyle, environmental exposure, or inborn or inherited characteristic, which, on the basis of epidemiologic evidence, is known to be associated with a health-related condition considered important to prevent.Guideline Adherence: Conformity in fulfilling or following official, recognized, or institutional requirements, guidelines, recommendations, protocols, pathways, or other standards.OregonTomography, X-Ray Computed: Tomography using x-ray transmission and a computer algorithm to reconstruct the image.Hospitals, Pediatric: Special hospitals which provide care for ill children.Utilization Review: An organized procedure carried out through committees to review admissions, duration of stay, professional services furnished, and to evaluate the medical necessity of those services and promote their most efficient use.