Articles: emergency-medical-services.
-
This report was prepared by a task force of the Committee on Trauma of the American College of Surgeons. In June of 1986, the Board of Regents of the American College of Surgeons approved this report and authorized its publication as an official College document. It replaces similar documents published in 1976, 1979, and 1983. ⋯ The Committee on Trauma also considers rehabilitation a critical element for optimal care of the injured patient. It is generally recognized that this document is a set of guidelines representing current thinking for optimal care of the injured. Further revisions may be indicated as systems are developed to meet the complex demands of severely injured patients.
-
Treatment of pediatric trauma begins at the moment of injury (with the arrival of the first person who assists the victim), continues through transport of the patient to the hospital and administration of definitive medical care, and concludes with a rehabilitation program that is aimed at returning the child to a pre-accident life-style. Community hospitals can reduce morbidity and mortality associated with pediatric trauma by implementing specific organizational concepts and procedures used at established pediatric trauma centers. ⋯ Morbidity and mortality could be further reduced with a national system of comprehensive regional treatment centers designed specifically for children. PAs who are familiar with the specific needs of seriously injured children can significantly influence community and professional responses to this growing area of medicine.
-
Casualties from a nuclear attack on the United Kingdom would overwhelm the health services, and health workers would be faced with many more people seeking help than could be offered treatment. Discussion is needed to determine which methods of medical and non-medical triage would be acceptable and feasible.
-
Implementation of a regional trauma care system requires a field triage tool that identifies the severely injured patient and transports him to a trauma center, while preserving the flow of minimally injured patients to community hospitals. We prospectively tested the Trauma Score (TS) as a field triage tool and evaluated its accuracy against that of the Injury Severity Score (ISS), calculated after the patients' injuries were fully defined. During an 18-month period, 1106 patients admitted to the trauma center at San Francisco General Hospital had a TS determined in the field (TS1) and on arrival at the emergency department. ⋯ Using an ISS of 20 or more as an indicator of life-threatening injury, we determined the predictive value of TS1. There were 66 false-negatives (ISS, greater than or equal to 20; TS1, 15 or 16) and 107 false-positives (ISS, less than 20; TS1, less than or equal to 14). Using a prehospital TS of 14 or less as an indicator of serious injury, only 20% of a major urban trauma population would qualify for diversion to a trauma center.