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1. A program of regionalization of critically injured trauma patients has been ongoing in Illinois since July 1, 1973. 2. The Illinois trauma system was initiated with the functional categorization of some 47 local, areawide, and regional and three special regional hospital trauma centers strategically located across the state, and established a frame-work for a statewide comprehensive emergency medical services program. 3. Program concepts, subsystems components, and trauma registry clinical data have been presented to describe the dynamics of this trauma-EMS care system. 4. Trauma patient care, because of its complex requirements, provides an excellent model from which to design a basic emergency health care delivery system, and one that can be expanded to include all types of emergency medical problems. 5. Because of the obvious demanding clinical needs of critically injured trauma patients for comprehensive care and the necessity for consolidation of medical resources for these patients at all community levels, surgeons should take a leadership role in regional and areawide trauma-EMS planning and implementation in their local communities.