Isolated transient loss of consciousness is an indicator of significant injury.

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Abstract
SINCE THE late 1970s, the concept of concentrating resources and skills in trauma centers to facilitate optimal care of injured patients has become well accepted in the United States.1 West et al1 demonstrated that victims of blunt trauma who were cared for in a hospital designated and prepared to receive all local trauma cases were less likely to suffer a preventable death than patients with similar injuries cared for in hospitals not specifically organized to provide trauma care. Although the trauma center concept has been generally accepted since that article, which patients should be taken to trauma centers remains the subject of controversy.