Looking at contemporary pre-hospital trauma care systems

Care for patients suffering from major trauma varies greatly throughout the world. This may range from no response at all, to advanced systems comprising multiple levels of response. Much of the understanding of the management of civilian trauma has been drawn from military experience in times of war. Holistic, integrated trauma systems are well-established in many parts of the developed world. These contemporary trauma systems are complex, can be costly, and are a significant undertaking to establish.Controversy surrounds the level of pre-hospital response, and the in-field skills required to improve patient outcomes. The ideal resourcing for pre-hospital response to trauma is not agreed upon, and requires further investigation. However, significant reductions in morbidity, mortality, suffering and societal burden can be expected following the establishment of an integrated trauma care system. A tiered response, encompassing basic and advanced level providers, who ultimately deliver patients to Major Trauma Centres, appears to be current best practice.

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