The Wall Street Journal on Wednesday examined problems with the U.S. trauma care system.

According to the American College of Surgeons, each year, trauma from injuries causes 140,000 deaths and 80,000 permanent disabilities among U.S. adults younger than age 44, but only 25% of those adults live in areas with a coordinated system to refer patients to designated trauma care facilities. In addition, a recent federal survey of state trauma care systems also found only eight met federal preparedness guidelines.

Efforts have begun to establish a national trauma care system to ensure referral of patients to designated trauma care facilities, but "funding is tight," the Journal reports. Since 1990, the federal government has provided states with only $34.1 million to develop trauma systems, although a law passed earlier this year will provide an additional $12 million.

A. Brent Eastman, a trauma specialist at ACS and chief medical officer at Scripps Health, said, "While patients can pick and choose where to go for elective procedures, if you are in a car accident or fall off a ladder, you are at the mercy of the system -- or the lack of a system," adding, "Americans think if they call 911 that everything is going to be taken care of, but there has to be a trauma system in place to ensure that you are taken to a center that can provide the level of care commensurate to the degree of your injury" (Landro, Wall Street Journal, 10/3).