TRAUMA  CARE SYSTEMS || TCS Mgr. Lucia Lenartova
OVERVIEW 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: Prehospital Emergency Medical Services Acute Care Rehabilitation
IMPORTANT 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  increased RISK Children (>1)……EMS-C Elderly people (>65)
Trauma System Management regional tcs local tcs
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
Outcomes Relies on population based registries Analyze mortality outcomes Shifting more seriously injured patients to trauma centers Identify elements of TCS-most responsible for reduction in morbidity and mortality
Outcome measures focus on survival, return to normal everyday activities measure assess outcomes through questionnaires understanding of patient risk factors
Costs of TCS incurred by multiple organizations fall under multiple categories objectively measured patients outcomes and costs
Cost-effectiveness of TCS  in USA lower medical costs increased workers productivity helicopter transport determine  most cost-effective elements
Abstracts  1: Am J Surg. 1991 Feb: 61 (2):226-9 Trauma systems in Europe Allgower M. first helicopter air rescue system in Switzerland creation of TCS within large hospital settings
Abstracts 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 databank guidelines control
Abstracts 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 TCS consider individual trauma patient nationwide trauma registration data base remaining problems
Abstracts 1:Injury 2003 Sep,34(9):669-73 Trauma care systems in France Masmejean EH,Faye A,Alnot JY,Mignon AF prehospital medically assisted care no specialization in trauma
Abstracts 1: Injury 2003 Sep,34(9):709-19 Trauma care in Spain Queipo de Llano E,Mantero Ruiz A, prehospital clinical history ICU professional training need for professional training in ATLS
Abstracts 1:Injury 2003 Sep,34(9):735-9 Trauma care systems in United States Blackwell T,Kellam JF,Thomason M in the process of evolution guidelines of the ACS(American College of Surgeons) need to extend the system to all trauma patients
Abstracts 1: Pryegl Lek.2000,57 Suppl:127-8 Trauma care for the year 2000 Bielecki K. trauma is third killer of modern society create trauma care centers well trained medical staff  optimalization of patient transport
Abstracts 1:Ned Tjidschr Geneeskd.2001 Dec,145(48):2321-6 Use of trauma triage teams at the café fire in Volendam Boxma H need for secondary triage-patients transfer protocol for the care of patients with serious burns
Abstracts 1: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
Abstracts 1:Clin Orthop.1995 Sep,(318):25-35 The management of polytraumatized patients in Germany Haas NP,Hoffmannn RF,Mauch C well organised polytrauma systems wide use of helicopters special rescue coordination centers
Abstracts 1:Ann R Coll Surg Engl,2000 Jan,82(1):49-52 Watson Jones Lecture.The organisation of trauma services in the UK Templeton J UK require modification in TCS
Thank you for your attention

15 trauma care systems

  • 1.
    TRAUMA CARESYSTEMS || TCS Mgr. Lucia Lenartova
  • 2.
    OVERVIEW OF TCSorganized 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.
    3 major providers:Prehospital Emergency Medical Services Acute Care Rehabilitation
  • 4.
    IMPORTANT COMPONENTS Provideleadership Coordinate delivery Minimum standards of care Designate trauma centers Ensure system evaluation Medical direction Prevention Communication Training Triage Prehospital care Transportation Etc.
  • 5.
    POPULATIONS under increased RISK Children (>1)……EMS-C Elderly people (>65)
  • 6.
    Trauma System Managementregional tcs local tcs
  • 7.
    Prevention,surveillance, research inTCS 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.
    Outcomes Relies onpopulation based registries Analyze mortality outcomes Shifting more seriously injured patients to trauma centers Identify elements of TCS-most responsible for reduction in morbidity and mortality
  • 9.
    Outcome measures focuson survival, return to normal everyday activities measure assess outcomes through questionnaires understanding of patient risk factors
  • 10.
    Costs of TCSincurred by multiple organizations fall under multiple categories objectively measured patients outcomes and costs
  • 11.
    Cost-effectiveness of TCS in USA lower medical costs increased workers productivity helicopter transport determine most cost-effective elements
  • 12.
    Abstracts 1:Am J Surg. 1991 Feb: 61 (2):226-9 Trauma systems in Europe Allgower M. first helicopter air rescue system in Switzerland creation of TCS within large hospital settings
  • 13.
    Abstracts 1:Anasthesiol IntensivNotfallmed 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 databank guidelines control
  • 14.
    Abstracts 1: Injury2003 Sep,34(9):722-7 Trauma care systems in The Netherlands Jan ten Duis H,van der Werken C. quality improvement in TCS consider individual trauma patient nationwide trauma registration data base remaining problems
  • 15.
    Abstracts 1:Injury 2003Sep,34(9):669-73 Trauma care systems in France Masmejean EH,Faye A,Alnot JY,Mignon AF prehospital medically assisted care no specialization in trauma
  • 16.
    Abstracts 1: Injury2003 Sep,34(9):709-19 Trauma care in Spain Queipo de Llano E,Mantero Ruiz A, prehospital clinical history ICU professional training need for professional training in ATLS
  • 17.
    Abstracts 1:Injury 2003Sep,34(9):735-9 Trauma care systems in United States Blackwell T,Kellam JF,Thomason M in the process of evolution guidelines of the ACS(American College of Surgeons) need to extend the system to all trauma patients
  • 18.
    Abstracts 1: PryeglLek.2000,57 Suppl:127-8 Trauma care for the year 2000 Bielecki K. trauma is third killer of modern society create trauma care centers well trained medical staff optimalization of patient transport
  • 19.
    Abstracts 1:Ned TjidschrGeneeskd.2001 Dec,145(48):2321-6 Use of trauma triage teams at the café fire in Volendam Boxma H need for secondary triage-patients transfer protocol for the care of patients with serious burns
  • 20.
    Abstracts 1:Med Teach.2003Mar,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
  • 21.
    Abstracts 1:Clin Orthop.1995Sep,(318):25-35 The management of polytraumatized patients in Germany Haas NP,Hoffmannn RF,Mauch C well organised polytrauma systems wide use of helicopters special rescue coordination centers
  • 22.
    Abstracts 1:Ann RColl Surg Engl,2000 Jan,82(1):49-52 Watson Jones Lecture.The organisation of trauma services in the UK Templeton J UK require modification in TCS
  • 23.
    Thank you foryour attention