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Trauma is the leading cause of death among people aged between 1 and 38 years, and it is the third leading cause of death in people of all ages. Over 150 000 deaths and 350 000 permanent disablements occur each year in the United States as a result of accidents, suicides, and homicides. In 1982 alone, trauma is estimated to have cost the United States over 60 billion dollars, with one third attributed to treatment costs and the remaining to lost earnings. Since trauma primarily affects younger people in the earlier stages of their productive work years, it exacts a higher cost in terms of lost years of potential than that of cardiovascular disease and cancer combined. In California, two thirds of all trauma patients are involved in "blunt" trauma, usually from highway-related traffic accidents. The remaining third are involved in penetrating trauma. The trauma milieu is defined by the