Since the advent of trauma systems in the USA in the 1960s, the treatment of traumatic injuries has evolved considerably. Although the magnitude of impact differs across geographies and time frames, the value of trauma centres in reducing mortality from a variety of injury mechanisms has now been well documented. A national evaluation of trauma centres found approximately 20%–25% lower mortality in both inpatients and at 1 year postdischarge for trauma centre-treated patients compared with those treated in non-trauma centres.1 Compared with these national numbers, motor vehicle crash patients had an adjusted improved survival of 9%2 with a third study that used a meta-analysis approach finding a 15% lowered mortality.3

Key features of trauma centres include teams of surgeons and specialists equipped to provide comprehensive medical care through the application of well-developed and timely infrastructure, technology and support personnel. While the criteria for the categorisation of trauma centre capabilities vary across states, …