Prelude
The practice of medicine has changed dramatically since you were born. Consider a few of these changes:
• Vaccines are now available for chicken pox and human papilloma virus;
• Microarrays allow rapid patient-specific testing for mutations in genes controlling metabolism of potentially toxic drugs;
• Inexpensive contact lenses provide clear vision;
• Prosthetic legs allowed a double-amputee to run in the Olympics;
• Ultrasound imaging follows the progress of pregnancy with ever greater precision;
• Stem cells in human cord blood have been used to treat dozens of diseases in donors, or their siblings;
• An iPhone app driving a bionic pancreas offers better control of diabetes.
For your parents, the changes have been even more sweeping. Overall life expectancy—that is, the span of years that people born in a given year are expected to live—increased from 50 in 1900 to almost 80 by 2010 (Figure 1.1). You can expect to live 30 years longer than your great-grandparents; you can also expect to be healthier and more active during all the years of your life.
How has this happened? One answer is obvious. People are living longer because they are not dying in situations that were previously fatal, such as childbirth and bacterial infections. Biomedical engineering is a major factor in this extension of life and improvement of health. Biomedical engineers have contributed to every field of medicine—from radiology to obstetrics to cancer treatment to control of diabetes. The next few paragraphs illustrate the far-reaching contributions of biomedical engineers with examples from emergency medicine.
Loss of life in accidents and trauma is a major cause of death and disability around the world. In the United States, it is overwhelmingly the leading cause of death among people of college age, and it is ranked fifth among causes of death for all ages (1).
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