Abstract
The origins of the US Civilian Trauma and Emergency Medical Services Systems (EMSS) started in the 1970s are presented. The conceptual basis, strategic, and tactical implementation approaches used to establish the national program are described. The trauma and other clinical systems were extensions of proven clinical methods initially from cardiac and trauma units and deployed in new settings. The overall systems design was regionalization. Professionals, governmental agents, the public, and politicians all worked together to establish local, regional, state, and a nationwide comprehensive trauma/EMSS program that touch every state, territory, and community. A historical narrative is presented.