Texas Trauma System Commemorates 35 Years of Saving Lives

AUSTIN – (August 14, 2024) The history of trauma care response can be found dating back to the medical treatment of injured military personnel during the Civil War. The processes used then were documented and have significantly progressed over time. In the 1980s, 70-80% of trauma deaths from automobile accidents occurred on rural roads and injuries cost Texans $10.8 billion. At that time, most rural hospitals did not have the specialized training to treat traumatic injuries, and some urban hospitals could not take a patient transfer. It was estimated that by the early 1990s, nearly 70,000 Texans would be seriously injured. A group of trauma leaders across Texas knew that care had to improve.

These trauma leaders, comprised of trauma surgeons, trauma nurses, and state government leaders, believed that a more integrated system at regional levels could improve care. In 1989, during the 71st Texas Legislature, House Bill (HB) 18, known as the Omnibus Rural Health Care Rescue Act, was passed. This legislation directed the development of an emergency medical service (EMS) and trauma care system, allowed for the creation of the Trauma Service Areas (TSAs) and the formation of the Regional Advisory Councils (RACs), and outlined the trauma facility designation process. This created the Texas Trauma System, which is the coordination of available resources to respond to emergency health care needs. This includes emergency medical services, local hospitals, and specialized hospitals

Kathy Perkins, RN, MBA, is one of the founders of the Texas Trauma System. She spent nearly 30 years in state government, working with stakeholders to develop and implement the first rules, policies, procedures, and documents for implementation of the Texas Trauma System. Perkins retired from the Texas Department of State Health Services as the assistant commissioner for regulatory services.

“The creation of the Texas Trauma System was built by health care professionals in their spare time and has since saved thousands of lives,” said Kathy Perkins. “When the system was created, it brought health care and emergency care professionals together in a way that had never happened and now they have a well-coordinated, established working relationship that has improved the response and care for a trauma patient.”

Two trauma surgeons who were also fundamental in developing the trauma system are Kenneth Mattox, M.D., FACS and the late James “Red” Duke, M.D. In their careers, the two renowned surgeons successfully led numerous developments that strengthened trauma care in Texas. Dr. Duke was instrumental in establishing Memorial Hermann’s Flight for Life program in Houston and Dr. Mattox developed the internationally known Ben Taub Hospital Emergency Center in Houston, where he was chief of staff and surgeon-in-chief.

“Trauma surgeons and other trauma care leaders must always seek for the best way to serve patients and that’s what we did with the Texas Trauma System,” Dr. Mattox said. “By going to the heart of the challenge, which at that time the challenge was providing trauma care in rural areas, we found a way to provide care in those areas with every component of trauma care working with the appropriate individuals.”

The concerted response in the Texas Trauma System is based on regional trauma system plans through the 22 RACs across Texas that partner with prehospital and hospital providers and optimize the delivery of time-sensitive medical care. Today, their work is amplified when disasters strike as they coordinate the response during hurricanes, wildfires, and acts of violence. Wanda Helgesen, RN, MSN, worked to establish Trauma Service Area I in El Paso, known as the Border Regional Advisory Council (BorderRAC).

“Each RAC understands the needs of its unique region and how care is delivered,” Helgesen said. “The response and resources are not the same in the El Paso area as it would be in Houston, for example. Understanding the regional differences, along with sustaining relationships with the other RACs is key to ensuring success in the trauma system.”

Helgesen is the chair of the board of directors for the Texas EMS, Trauma & Acute Care Foundation (TETAF), Mattox is a current and long-serving board member, and Perkins is a past board member. TETAF is the only Texas-based source for hospital trauma, stroke, neonatal, and maternal levels of care verification surveys and resources. The verification surveys are part of the trauma facility designation process established as part of the Texas Trauma System to ensure hospitals meet the criteria for the level of designation sought by the hospital.

“The Texas Trauma System is strong today because of these remarkable visionaries who united to improve care to trauma patients in Texas,” Dinah Welsh, TETAF president and CEO, said. “The work to have a world-class trauma system in Texas continues today with founders of the system and so many exceptional experts across the state who have taken an active role since its creation. Without question, it is with gratitude to all these leaders that tens of thousands of lives are saved each year in Texas because of their contributions to the Texas Trauma System.”

TETAF will commemorate the 35th anniversary of the Texas Trauma System by establishing the TETAF Rural Trauma System Development Fund, which will support the ongoing needs of rural trauma caregivers.