Trauma System and Rescue Strategies - Schnüriger, Beat; Hautz, Wolf E. (2022)
A trauma system is a prearranged approach to trauma patients in a defined geographical area that provides full and optimal care. Trauma care systems are most effective, when they incorporate routine system evaluation, quality management, and are based on a needs assessment. Triaging polytraumatized patients to hospitals that are incapable of providing definitive care is associated with increased mortality. Therefore, it is of paramount importance to accurately select trauma victims, that will benefit the most from the resources of a Level I trauma center. Especially patients with occult hemorrhagic shock, elderly patients with more co-morbidities, and patients with traumatic brain injury who require operative intervention are susceptible for undertriage. Currently, no single field triage score has been accepted as the gold standard and there is need for improvement of the prehospital triage protocol. In the prehospital setting, a trauma victim may be assessed by a provider able to provide basic life support (BLS) or advanced life support (ALS). While prehospital ALS has theoretical advantages, the evidence supporting its effectiveness for trauma is limited, however, with the trials having methodological problems. Nevertheless, it is vital that the prehospital trauma care providers always consider the delay to definitive care against the potential benefit from the field treatment such as endotracheal intubation or administration of i.v. Fluids. © Springer Nature Switzerland AG 2011, 2016, 2022, corrected publication 2022.
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