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TRAUMA CARE SYSTEMS || TCS

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.

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TRAUMA CARE SYSTEMS || TCS

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  1. TRAUMA CARE SYSTEMS||TCS Mgr. Lucia Lenartova

  2. 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. 3 major providers: • Prehospital Emergency Medical Services • Acute Care • Rehabilitation

  4. Provide leadership Coordinate delivery Minimum standards of care Designate trauma centers Ensure system evaluation Medical direction Prevention Communication Training Triage Prehospital care Transportation Etc. IMPORTANT COMPONENTS

  5. POPULATIONS under increased RISK • Children (>1)……EMS-C • Elderly people (>65)

  6. Trauma System Management • regional tcs • local tcs

  7. Prevention,surveillance,research in TCS

  8. 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

  9. Outcome measures • focus on survival, return to normal everyday activities • measure assess outcomes through questionnaires • understanding of patient risk factors

  10. Costs of TCS • incurred 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 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

  14. 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

  15. 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

  16. 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

  17. 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

  18. 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

  19. 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

  20. 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

  21. 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

  22. 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

  23. Thank you for your attention

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