Brazos Valley Regional Advisory Council
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Emergency Trauma System Overview

It is necessary to understand EMS and trauma systems in order to assess emergency medical needs in a community. Patients must reach definitive care within a short period of time to help prevent death or disability. To ensure this occurs, a set of resources must be in place and immediately accessible at all times. These resources include informed citizens, communications systems, pre-hospital care providers and multidisciplinary trauma teams in emergency departments. With the inclusion of public information, prevention activities and rehabilitation, this coordination of resources is called an EMS/trauma system. While emergency health care, including some emergency medical services, had been available for many years, the Texas EMS/Trauma System as it exists today began in 1989 with passage of the Omnibus Rural Health Care Rescue Act. Designed to help rural areas gain access to more health resources, that legislation ultimately led to the division of Texas into 22 trauma service areas (TSAs), identified alphabetically from A to V. Regional advisory councils (RACs) have been established in each TSA. Although RACs were created to improve emergency and trauma health care in the state, they have expanded their focus to include disaster planning and management of all medical emergencies. RACs work with their local EMS providers, hospitals and designated trauma facilities to ensure that guidelines are in place for responding to specific medical emergencies—no matter where the patient is in that geographic area.


For example, a RAC’s guidelines may suggest that patients with certain types of injuries be taken to a specialized facility, such as a designated Level I trauma facility. Emergency medical services and trauma care are vitally important to every community in Texas. From its humble beginnings as a patient transport system run by funeral homes, the Texas EMS/Trauma system has evolved into a key player in emergency care both as part of daily life and during disasters. The public now expects EMS to be just a 9-1-1 call away—available quickly, anytime, anywhere. However, because EMS is not defined statutorily as an essential service that must be provided locally, many communities struggle to make this perception of “anytime, anywhere” a reality.