TRAUMA  CARE SYSTEMS || TCS Mgr. Lucia Lenartova
OVERVIEW OF TCS <ul><li>organized and coordinated effort in a defined geographic area to deliver the full spectrum of care...
3 major providers: <ul><li>Prehospital Emergency Medical Services </li></ul><ul><li>Acute Care </li></ul><ul><li>Rehabilit...
IMPORTANT COMPONENTS <ul><li>Provide leadership </li></ul><ul><li>Coordinate delivery </li></ul><ul><li>Minimum standards ...
POPULATIONS under  increased RISK <ul><li>Children (>1)……EMS-C </li></ul><ul><li>Elderly people (>65) </li></ul>
Trauma System Management <ul><li>regional tcs </li></ul><ul><li>local tcs  </li></ul>
Prevention,surveillance, research in TCS Research Surveillance Prevention TS research placement etiology,scope of injury p...
Outcomes <ul><li>Relies on population based registries </li></ul><ul><li>Analyze mortality outcomes </li></ul><ul><li>Shif...
Outcome measures <ul><li>focus on survival, return to normal everyday activities </li></ul><ul><li>measure assess outcomes...
Costs of TCS <ul><li>incurred by multiple organizations </li></ul><ul><li>fall under multiple categories </li></ul><ul><li...
Cost-effectiveness of TCS  in USA <ul><li>lower medical costs </li></ul><ul><li>increased workers productivity </li></ul><...
Abstracts  <ul><li>1: Am J Surg. 1991 Feb: 61 (2):226-9 </li></ul><ul><li>Trauma systems in Europe </li></ul><ul><li>Allgo...
Abstracts <ul><li>1:Anasthesiol Intensiv Notfallmed Schmerzther,2000 Oct,35(10):630-4 </li></ul><ul><li>The treatment of s...
Abstracts <ul><li>1: Injury 2003 Sep,34(9):722-7 </li></ul><ul><li>Trauma care systems in The Netherlands </li></ul><ul><l...
Abstracts <ul><li>1:Injury 2003 Sep,34(9):669-73 </li></ul><ul><li>Trauma care systems in France </li></ul><ul><li>Masmeje...
Abstracts <ul><li>1: Injury 2003 Sep,34(9):709-19 </li></ul><ul><li>Trauma care in Spain </li></ul><ul><li>Queipo de Llano...
Abstracts <ul><li>1:Injury 2003 Sep,34(9):735-9 </li></ul><ul><li>Trauma care systems in United States </li></ul><ul><li>B...
Abstracts <ul><li>1: Pryegl Lek.2000,57 Suppl:127-8 </li></ul><ul><li>Trauma care for the year 2000 </li></ul><ul><li>Biel...
Abstracts <ul><li>1:Ned Tjidschr Geneeskd.2001 Dec,145(48):2321-6 </li></ul><ul><li>Use of trauma triage teams at the café...
Abstracts <ul><li>1:Med Teach.2003 Mar,25(2):142-8 </li></ul><ul><li>Training pre-hospital trauma care in low-income count...
Abstracts <ul><li>1:Clin Orthop.1995 Sep,(318):25-35 </li></ul><ul><li>The management of polytraumatized patients in Germa...
Abstracts <ul><li>1:Ann R Coll Surg Engl,2000 Jan,82(1):49-52 </li></ul><ul><li>Watson Jones Lecture.The organisation of t...
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15 trauma care systems

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15 trauma care systems

  1. 1. TRAUMA CARE SYSTEMS || TCS Mgr. Lucia Lenartova
  2. 2. OVERVIEW OF TCS <ul><li>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 </li></ul>
  3. 3. 3 major providers: <ul><li>Prehospital Emergency Medical Services </li></ul><ul><li>Acute Care </li></ul><ul><li>Rehabilitation </li></ul>
  4. 4. IMPORTANT COMPONENTS <ul><li>Provide leadership </li></ul><ul><li>Coordinate delivery </li></ul><ul><li>Minimum standards of care </li></ul><ul><li>Designate trauma centers </li></ul><ul><li>Ensure system evaluation </li></ul><ul><li>Medical direction </li></ul><ul><li>Prevention </li></ul><ul><li>Communication </li></ul><ul><li>Training </li></ul><ul><li>Triage </li></ul><ul><li>Prehospital care </li></ul><ul><li>Transportation </li></ul><ul><li>Etc. </li></ul>
  5. 5. POPULATIONS under increased RISK <ul><li>Children (>1)……EMS-C </li></ul><ul><li>Elderly people (>65) </li></ul>
  6. 6. Trauma System Management <ul><li>regional tcs </li></ul><ul><li>local tcs </li></ul>
  7. 7. Prevention,surveillance, research in TCS Research Surveillance Prevention TS research placement etiology,scope of injury problem control health costs gaps in knowledge asses system performance improve safety active research program monitor outcomes improve health
  8. 8. Outcomes <ul><li>Relies on population based registries </li></ul><ul><li>Analyze mortality outcomes </li></ul><ul><li>Shifting more seriously injured patients to trauma centers </li></ul><ul><li>Identify elements of TCS-most responsible for reduction in morbidity and mortality </li></ul>
  9. 9. Outcome measures <ul><li>focus on survival, return to normal everyday activities </li></ul><ul><li>measure assess outcomes through questionnaires </li></ul><ul><li>understanding of patient risk factors </li></ul>
  10. 10. Costs of TCS <ul><li>incurred by multiple organizations </li></ul><ul><li>fall under multiple categories </li></ul><ul><li>objectively measured patients outcomes and costs </li></ul>
  11. 11. Cost-effectiveness of TCS in USA <ul><li>lower medical costs </li></ul><ul><li>increased workers productivity </li></ul><ul><li>helicopter transport </li></ul><ul><li>determine most cost-effective elements </li></ul>
  12. 12. Abstracts <ul><li>1: Am J Surg. 1991 Feb: 61 (2):226-9 </li></ul><ul><li>Trauma systems in Europe </li></ul><ul><li>Allgower M. </li></ul><ul><li>first helicopter air rescue system in Switzerland </li></ul><ul><li>creation of TCS within large hospital settings </li></ul>
  13. 13. Abstracts <ul><li>1:Anasthesiol Intensiv Notfallmed Schmerzther,2000 Oct,35(10):630-4 </li></ul><ul><li>The treatment of severe head-brain injuries in Austria </li></ul><ul><li>Drobetz H,Freudenschuss B,Kutscha-Lissberg E,Buchinger W,Mauritz W </li></ul><ul><li>need for brain trauma databank </li></ul><ul><li>guidelines control </li></ul>
  14. 14. Abstracts <ul><li>1: Injury 2003 Sep,34(9):722-7 </li></ul><ul><li>Trauma care systems in The Netherlands </li></ul><ul><li>Jan ten Duis H,van der Werken C. </li></ul><ul><li>quality improvement in TCS </li></ul><ul><li>consider individual trauma patient </li></ul><ul><li>nationwide trauma registration data base </li></ul><ul><li>remaining problems </li></ul>
  15. 15. Abstracts <ul><li>1:Injury 2003 Sep,34(9):669-73 </li></ul><ul><li>Trauma care systems in France </li></ul><ul><li>Masmejean EH,Faye A,Alnot JY,Mignon AF </li></ul><ul><li>prehospital medically assisted care </li></ul><ul><li>no specialization in trauma </li></ul>
  16. 16. Abstracts <ul><li>1: Injury 2003 Sep,34(9):709-19 </li></ul><ul><li>Trauma care in Spain </li></ul><ul><li>Queipo de Llano E,Mantero Ruiz A, </li></ul><ul><li>prehospital clinical history </li></ul><ul><li>ICU professional training </li></ul><ul><li>need for professional training in ATLS </li></ul>
  17. 17. Abstracts <ul><li>1:Injury 2003 Sep,34(9):735-9 </li></ul><ul><li>Trauma care systems in United States </li></ul><ul><li>Blackwell T,Kellam JF,Thomason M </li></ul><ul><li>in the process of evolution </li></ul><ul><li>guidelines of the ACS(American College of Surgeons) </li></ul><ul><li>need to extend the system to all trauma patients </li></ul>
  18. 18. Abstracts <ul><li>1: Pryegl Lek.2000,57 Suppl:127-8 </li></ul><ul><li>Trauma care for the year 2000 </li></ul><ul><li>Bielecki K. </li></ul><ul><li>trauma is third killer of modern society </li></ul><ul><li>create trauma care centers </li></ul><ul><li>well trained medical staff </li></ul><ul><li>optimalization of patient transport </li></ul>
  19. 19. Abstracts <ul><li>1:Ned Tjidschr Geneeskd.2001 Dec,145(48):2321-6 </li></ul><ul><li>Use of trauma triage teams at the café fire in Volendam </li></ul><ul><li>Boxma H </li></ul><ul><li>need for secondary triage-patients transfer </li></ul><ul><li>protocol for the care of patients with serious burns </li></ul>
  20. 20. Abstracts <ul><li>1:Med Teach.2003 Mar,25(2):142-8 </li></ul><ul><li>Training pre-hospital trauma care in low-income countries:the Village University experience </li></ul><ul><li>Husum H </li></ul><ul><li>prospective study </li></ul><ul><li>mortality decrease for trauma patients </li></ul><ul><li>non-graduate health workers building rescue system </li></ul>
  21. 21. Abstracts <ul><li>1:Clin Orthop.1995 Sep,(318):25-35 </li></ul><ul><li>The management of polytraumatized patients in Germany </li></ul><ul><li>Haas NP,Hoffmannn RF,Mauch C </li></ul><ul><li>well organised polytrauma systems </li></ul><ul><li>wide use of helicopters </li></ul><ul><li>special rescue coordination centers </li></ul>
  22. 22. Abstracts <ul><li>1:Ann R Coll Surg Engl,2000 Jan,82(1):49-52 </li></ul><ul><li>Watson Jones Lecture.The organisation of trauma services in the UK </li></ul><ul><li>Templeton J </li></ul><ul><li>UK require modification in TCS </li></ul>
  23. 23. Thank you for your attention

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