Trauma was one of the first tribulations man faced. Experiencing injury when he was first introduced to fire, water, weather, or predators. Documented cases of trauma have been traced back to the Edwin Smith papyrus, written between 3000 and 1600 BC. Ancient Egypt, dating back as early as 6000 BC, had surgeons who preformed multiple tasks including: amputations, removal of cataracts, extraction of foreign bodies, and dressing wounds. There were multiple texts relating to burn care in the Ebers Papyrus, believed to be written in 156 BC. Sushruta, from Ancient India (2500 – 1500BC), described in text over 100 surgical instruments that he used. There are also multiple sources from ancient Greece where the father of modern medicine, Hippocrates lived. Surgery was flourishing treating the common injuries of fractures and dislocations and healing wounds. The Romans introduced a system of hospitals using tents in the field for military purposes. The first permanent hospital was built for the public in fifth century AD.

Trauma care was continually growing throughout the Middle Ages. Most importantly, there was methodical process and regulations to physician’s training, development of licensing examinations, and the insistence of a post graduate year spent with a private physician. The 18th century brought multiple technologically advanced methods for diagnose and care. These included cellular pathology, understanding of respiration and blood pressure, and inventing artificial ventilation. It was also in this century, that Diminque Jean Larrey developed the “ambulance volante” to fulfill the need for in-field trauma care and a more efficient means for transportation to definitive care.

Even with the influx of medical advancements, War World I brought war injuries at 66% mortality rate for abdominal wounds. However improvements were made as rudimentary antibiotics were introduced. World War II had superior advances in trauma methods. Blood transfusions were routine and auxiliary centers were placed closer to regular sites of injury were occurring. Eventually progress made its way across the Atlantic. In 1938, the American Association for the Surgery of Trauma (AAST) was formed to improve trauma care across the United States.

Like the previous battlefields provided experimental grounds for advances in trauma care; the Korean and Vietnam wars brought about progress in vascular surgery, the benefits of helicopter transport, and rapid surgical care for the severely wounded. Eventually medicine and trauma care was able to develop a specialized civilian trauma center. The first official center was established in Birmingham, England in 1941. The United States followed and trauma facilities emerged between 1966 and 1972. The Trauma System today is guided by such groups as the American College of Surgeons and the American Trauma Society. Improvements are also brought about through specific state trauma systems such as North Carolina Office of EMS.