Trauma Systems and Injury Prevention Flashcards
trauma systems/prevention
- historically, trauma viewed differently than diseases
- trauma avoidable, accidental
- little was done to:
- organize trauma care
- develop systematic approach to trauma
- development of US trauma systems paralleled growth of EMS
history and overview of trauma systems
- traumatic injury approach developed by the military influenced civilian approach
- seriously injured patients require rapid surgical intervention -> mortality decreased
- MEDEVAC system developed
- approached mirrored by trauma systems in maryland and illinois
- set stage for golden hour and rapid transport
trauma care system
- center designations
- hospitals are divided into levels from trauma care
- level 4 is the lowest level of care
- level 3 is next advanced care facility
- level 2 is the next
- level 1 is the highest level with all areas of medicine available to the patient if needed
- besides trauma designations there are other specialty considerations as well
level 4 trauma center
– Rural Community hospitals
– No Immediate surgical
Interventions needed
– They primarily stabilize patients enough for transfer to High level Center
level 3 trauma center
-Community trauma centers
– They have a specialized ED with majority of surgical and medical subspecialties available 24/7 (on Call)
level 2 trauma center
-Area trauma centers
– They have a majority of surgical and medical subspecialties available 24/7
-No minimum patient criteria
– Surgical capability available in a “reasonably acceptable time”
– General surgeon present at resuscitation
– Desirable to have residents
– No research minimum
level 1 trauma center
-Regional trauma centers
– They have all surgical and medical subspecialties available 24/7
– They also have a research and educational commitment
– 1,200 trauma admissions/year
– Immediate surgical capability available
– In-house trauma surgeon
– General surgery residency program or trauma fellowship
– Research
specialty centers
-Some Patients will require treatment at a specific hospital.
-These include but are not limited to:
– Neurosurgery
– Pediatric Trauma
– Hyperbaric Chamber
– Burn Center
– SANE (Sexual Assault Nurse Examiner) Center
– Microsurgery
goals of trauma care system
- to integrate: EMS system/services and hospital care
- reduce- cost of care, time to surgery, mortality rate
- expedite definitive care- immediate surgical intervention to repair injury
integration of EMS
- the front lines of trauma systems
- try to prevent injuries from happening
- through education, assistance in public health programs
- start initial triage and care
- correct any threats to homeostasis
- make decisions about hospital destination
- Rapid Transport to definitive care
- Help track statistics by proper reportin
hospital care
- definitive hospital care
- Initial Stabilization of Patient
- Transfer to Specialty Service If Needed
- Short Term and Tertiary Care
- Discharge with appropriate Environment, Resources, Medications, and Care plan.
phases of traumatic injury
-1. pre-event- encompasses all the factors/circumstances that lead up to the injury.
-2. Event: It is the moment the actual trauma occurs.
-3. Post-event: All actions and consequences that resulted from
the occurrence of an injury.
pre-event
- Where most Trauma can be avoided through aggressive prevention policies and practices.
- Where all factors that lead up to the event come into play.
- All variables are considered here.
- Examples: Age, Physical Condition, PMH, Safe equipment used, speed, weather.
- Prevention has its role here
injury
An harmful Event that arises from the release of specific forms of physical energy or barriers to normal flow of energy.
epidemiological triad
- Three things needed for an injury to occur
- Host - Person or Organism
- Agent - Something that causes the Injury
- Environment – Suitable environment in which to two can come together
