Trauma systems in North America.

North American trauma systems are well developed yet vary widely in form across the continent. Comparatively, the Canadian trauma system is more unified, and approximately 80% of Canadians live within 1 hour of a level I or II center. In the United States, trauma centers are specifically verified by the individual states and thus there tends to be more variability across the country. Although many states use the criteria developed by the American College of Surgeons Committee on Trauma, the individual agencies are free to utilize their own verification standards. Both Canada and the United States utilize efficient prehospital care, and both countries recognize that postdischarge care is a financial challenge to the system. Population dense areas offer rapid admission to well-developed trauma centers, but injured patients in remote areas may have challenges regarding access. Trauma centers are classified according to their capabilities from level I (highest ability) to level IV. Although each trauma system has opportunities for improvement, they both provide effective access and quality care to the vast majority of injured patients.