Homicide death in Los Angeles comes three ways, says the Los Angeles Times. There is the quick death with a bullet to the brain or heart. There is the slower end that comes to those who bleed to death. Then there’s the slowest death of all – by organ failure or infection after surgery. A shooting victim profiled by the Times faced the third danger. He was out of surgery. But his blood wasn’t clotting and it seeped from a thousand microscopic places. His organs were in bad shape.
In a review of modern trauma medicine, the Times says that much of the change can be summed up in one word: Time. Get a patient into surgery fast and death rates plummet. Two years ago, researchers from the University of Massachusetts and Harvard estimated that without improvements in medicine since 1960 – particularly in trauma care – national homicide figures could be triple their current levels. The location of a high-level trauma center closer to where victims are being injured is one of the most significant of these improvements, because it allows them to be operated on quickly. Trauma care in Los Angeles consists of a cooperative network of 13 trauma centers, paramedics, and a triage system. One principle for decision makers to consider is the need to “allocate your resources close to the area of highest incidence of injury,” said assistant surgery professor Stephen Thomas of Harvard University.