Development of pre-hospital trauma-care system--an overview

Trauma is recognized as a serious health care problem world-wide and there is a general agreement that trauma is best addressed in a systematic manner. Accordingly, trauma systems must be designed to use efficiently the limited health care resources available. The majority of injuries are of only minor, or moderate, severity, and can be managed well at local community hospitals. On the other hand, a significant minority of injured patients will require extensive and expensive care in order to survive, or to minimize the morbidity of injury. For a trauma system to be optimally effective, given limited available resources and the need for urgent care of the seriously injured, it is critical to utilize a method of differentiating those injury victims, who need the specialized expertise and resources available in trauma centres, from those who can be cared for adequately locally. Rapid field assessment of injured patients is, therefore, an essential element of any effectively functioning trauma system. This review examines the evolution of pre-hospital trauma-care systems, during the triage of a trauma victim.