15 trauma care systems

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TRAUMA CARE SYSTEMSTRAUMA CARE SYSTEMS||||

TCSTCS

Mgr. Lucia Lenartova

OVERVIEW OF TCSOVERVIEW OF TCS

organized and coordinated effort in a defined geographic area to deliver the full spectrum of care to an injured patient from the the time of the injury through transport to an acute care facility and to rehabilitative care

3 major providers:3 major providers:

Prehospital Emergency Medical ServicesAcute CareRehabilitation

IMPORTANT COMPONENTSIMPORTANT COMPONENTS

Provide leadership Coordinate delivery Minimum standards of

care Designate trauma

centers Ensure system

evaluation

Medical direction Prevention Communication Training Triage Prehospital care Transportation Etc.

POPULATIONS under POPULATIONS under increased RISKincreased RISK

Children (>1)……EMS-C

Elderly people (>65)

Trauma System ManagementTrauma System Management

regional tcs

local tcs

Prevention,surveillance,Prevention,surveillance,research in TCSresearch in TCS

Prevention Surveillance Research

improve health monitor outcomes

active research program

improve safety asses system performance

gaps in knowledge

control health costs

etiology,scope of injury problem

TS research placement

OutcomesOutcomes

Relies on population based registriesAnalyze mortality outcomesShifting more seriously injured patients to

trauma centersIdentify elements of TCS-most responsible

for reduction in morbidity and mortality

Outcome measuresOutcome measures

focus on survival, return to normal everyday activities

measure assess outcomes through questionnaires

understanding of patient risk factors

Costs of TCSCosts of TCS

incurred by multiple organizationsfall under multiple categoriesobjectively measured patients outcomes and

costs

Cost-effectiveness of TCS Cost-effectiveness of TCS in USAin USA

lower medical costs increased workers productivityhelicopter transportdetermine most cost-effective elements

Abstracts Abstracts 1: Am J Surg. 1991 Feb: 61 (2):226-9

Trauma systems in Europe

Allgower M.first helicopter air rescue system in

Switzerlandcreation of TCS within large hospital

settings

AbstractsAbstracts

1:Anasthesiol Intensiv Notfallmed Schmerzther,2000 Oct,35(10):630-4

The treatment of severe head-brain injuries in Austria

Drobetz H,Freudenschuss B,Kutscha-Lissberg E,Buchinger W,Mauritz W

need for brain trauma databankguidelines control

AbstractsAbstracts

1: Injury 2003 Sep,34(9):722-7

Trauma care systems in The Netherlands

Jan ten Duis H,van der Werken C.quality improvement in TCSconsider individual trauma patientnationwide trauma registration data baseremaining problems

AbstractsAbstracts

1:Injury 2003 Sep,34(9):669-73

Trauma care systems in France

Masmejean EH,Faye A,Alnot JY,Mignon AFprehospital medically assisted careno specialization in trauma

AbstractsAbstracts

1: Injury 2003 Sep,34(9):709-19

Trauma care in Spain

Queipo de Llano E,Mantero Ruiz A,prehospital clinical historyICU professional trainingneed for professional training in ATLS

AbstractsAbstracts

1:Injury 2003 Sep,34(9):735-9Trauma care systems in United StatesBlackwell T,Kellam JF,Thomason Min the process of evolutionguidelines of the ACS(American College of

Surgeons)need to extend the system to all trauma

patients

AbstractsAbstracts

1: Pryegl Lek.2000,57 Suppl:127-8

Trauma care for the year 2000

Bielecki K.trauma is third killer of modern societycreate trauma care centerswell trained medical staff optimalization of patient transport

AbstractsAbstracts1:Ned Tjidschr Geneeskd.2001

Dec,145(48):2321-6Use of trauma triage teams at the café fire

in VolendamBoxma Hneed for secondary triage-patients transferprotocol for the care of patients with serious

burns

AbstractsAbstracts1:Med Teach.2003 Mar,25(2):142-8

Training pre-hospital trauma care in low-income countries:the Village University experience

Husum H prospective study mortality decrease for trauma patients non-graduate health workers building rescue

system

AbstractsAbstracts

1:Clin Orthop.1995 Sep,(318):25-35

The management of polytraumatized patients in Germany

Haas NP,Hoffmannn RF,Mauch Cwell organised polytrauma systemswide use of helicoptersspecial rescue coordination centers

AbstractsAbstracts

1:Ann R Coll Surg Engl,2000 Jan,82(1):49-52

Watson Jones Lecture.The organisation of trauma services in the UK

Templeton JUK require modification in TCS

Thank you for your attentionThank you for your attention