This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Contact me when this article is cited  Related Content  • Related articles  • Similar articles in JAMA  Topic Collections  • Emergency Medicine  • Alert me on articles by topic

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

To the Editor: Dr Branas and colleagues¹ estimate the proportion of US residents having access to trauma centers within 45 and 60 minutes. Despite advances in trauma and emergency medical systems the motor vehicle crash death rate in rural areas remains twice that in urban areas.² There are 2 issues in this study that we believe warrant comment.

First, this study underestimates the access time to trauma centers for individuals who sustain major trauma, especially those injured in rural locations. We believe that the assumption of a 3.5-minute interval between helicopter service receipt of an emergency call to takeoff is not realistic. Based on conversations we have had with pilots and operators, the time from receipt of the 911 call to helicopter liftoff may be as much as 10 minutes. In addition, simultaneous dispatch of helicopters and ground ambulances is not universal in the United States.³ Such practices and large . . . [Full Text of this Article]

Daniel P. Davis, MD
Department of Emergency Medicine
University of California at San Diego

John R. Wish, PhD
j.wish@comcast.net
Portland, Ore

RELATED ARTICLES

Access to Trauma Centers—Reply
Charles C. Branas, Ellen J. MacKenzie, Justin C. Williams, and C. William Schwab
JAMA. 2005;294(14):1760.
EXTRACT | FULL TEXT  

Access to Trauma Centers in the United States
Charles C. Branas, Ellen J. MacKenzie, Justin C. Williams, C. William Schwab, Harry M. Teter, Marie C. Flanigan, Alan J. Blatt, and Charles S. ReVelle
JAMA. 2005;293(21):2626-2633.
ABSTRACT | FULL TEXT