Phases of Trauma Care

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Phases of Trauma Care

• Prehospital care
• Emergency Departments and Trauma Centers
• Rehabilitation Facilities

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Prehospital Care

• Triage decision scheme to determine best level of
  care required
• Initiation of care based on protocols
• Attempt to stabilize patient
• Rapid transport

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Emergency Departments

• Variable levels of equipment, training, and
  capabilities, from tertiary hospitals to very
  small community hospitals
• All responsible for initiation of management
• ATLS designed primarily as a regimented,
  prioritized approach to trauma care (in
  particular for survival in small center with
  little staff)
• Interhospital agreements to care for injuries
  beyond resources

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Trauma Center

• Hospital that meets certain readiness
  requirements for care of injured persons
• Categorized by level (usually 1 through 4) by
  capacity/capability
• Involves having the right personnel and equipment
  readily available for trauma care

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Trauma Centers

• Committed resources dedicated to caring for
  trauma patients
• Level I tertiary, 24 h a day trauma
  
  
  attending
• Level II community, not as comprehensive
• Level III community, fewer resources
• Level IV rural, stabilize and transfer

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Specialty Trauma Centers

• Pediatric Trauma
• Burn
• Spinal Cord Injury
• Hand
• Rehabilitation

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Advanced Trauma Life Support (ATLS)

• Systematic, prioritized approach to trauma care
• Guidelines for even non trauma center providers
  to effectively manage trauma patients until
  patient can get to definitive care

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ATLS The Primary Survey

• Simple ABCs Approach
• Airway with cervical protection
• Breathing
• Circulation
• Disability
• Exposure and environmental control

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A MODEL TRAUMA SYSTEM
Rehabilitation
Severe Injuries
Moderate Injuries
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Acute Care
TRAUMA SYSTEMS
Minor Injuries
Prehospital Care
Prevention
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Trauma Outcomes Have Improved Dramatically Since
1995
1995 75 of major trauma patients lived
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A trauma SYSTEM is a statewide system of care
that includes all providers prehospital,
hospital and rehabA trauma CENTER is a hospital
that meets certain requirements for the excellent
care of trauma patients. Trauma centers are a
part of a trauma system.
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Thank You !
American College of Surgeons COMMITTEE ON
TRAUMA Consultation Program for
Trauma Systems