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Trauma System and Rescue Strategies

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Textbook of Polytrauma Management

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Abstract

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.

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Author information

Authors and Affiliations

  1. Department of Visceral and Surgery and Medicine, Acute Care Surgery Team, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland

    Beat Schnüriger

  2. Department of Emergency Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland

    Wolf E. Hautz

Authors
  1. Beat Schnüriger
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  2. Wolf E. Hautz
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Editor information

Editors and Affiliations

  1. Department of Trauma Surgery, University Hospital Zürich, Zürich, Switzerland

    Hans-Christoph Pape

  2. Department of Orthopaedic Surgery & Sports Medicine, The University of South Florida Morsani College of Medicine, Tampa, FL, USA

    Joseph Borrelli Jr.

  3. Ernest E. Moore Shock Trauma Center at Denver Health, University of Colorado, Denver, CO, USA

    Ernest E. Moore

  4. Klinik für Traumatologie, University Hospital of Zürich, Zürich, Switzerland

    Roman Pfeifer

  5. Rocky Vista University, College of Osteopathic Medicine, Parker, CO, USA

    Philip F. Stahel

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Schnüriger, B., Hautz, W.E. (2022). Trauma System and Rescue Strategies. In: Pape, HC., Borrelli Jr., J., Moore, E.E., Pfeifer, R., Stahel, P.F. (eds) Textbook of Polytrauma Management . Springer, Cham. https://doi.org/10.1007/978-3-030-95906-7_4

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  • DOI: https://doi.org/10.1007/978-3-030-95906-7_4

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-95905-0

  • Online ISBN: 978-3-030-95906-7

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