The lack of a standardized method for the initial assessment of the trauma patient's condition and the skills to perform emergency lifesaving surgical techniques in rural Nebraska has led to the development of an Advanced Trauma Life Support (ATLS) course. There has been a direct correlation between the presentation of the course in several rural areas of Nebraska and the improved quality of trauma care apparent when the patients arrive at a definitive care hospital. The national development of a standardized ATLS course will improve the survival of trauma patients as has been experienced with the Advanced Cardiac Life Support course and cardiac patients.