Trauma care is a team based approach. The concept has evolved over time to become a subject itself. In contrast to the treatment that is initiated when the victim reaches hospital, the trauma care starts providing treatment at the time of first contact.
That contact is usually the site of injury.
Patient that sustains injury is a critical patient and can have a potential danger to his life if not attended promptly. And there is high chance of survival if they are provided with immediate care.
To understand this better, we must go to an era when trauma was managed with routine approach. There were no specialized centers for trauma care. Patients were brought to the institutions after getting injured and attended by medical officers who would analyze the injuries and then call specific departments that patient might need.
This kind of approach was okay for low velocity trauma. As we grew as society, we also developed a taste for speed. A side effect is high velocity trauma.
A high velocity trauma typically results in injuries that involve multiple places and multiple system of the body. Thus a patient of high velocity trauma may have fractures in multiple bones, bleeding abdominal organs, facial injuries and head injury.
It must be emphasized that these patients are very critical.
A patient having pelvic fracture, fracture of bilateral femora and head injury would surely die in few hours if not attended immediately by multiple specialties with all kinds of supportive measures and required surgical treatment if any.
Time is most important factor.
The treatment must be preferably started within one hour of injury, called golden hour. It has been observed that patients who are attended within Golden Hour have a higher survival rate than who are attended later than that.
It would be an uphill task to do this in routine institutions which are bound and tied to their own rules and regulation.
Therefore, concept of trauma center was born.
A trauma center is a hospital equipped to perform as a casualty receiving station for the emergency medical services by providing the best possible medical care for traumatic injuries 24 hours a day, 365 days per year.
Trauma centers are supported by pre hospital trauma care unit that goes to injury site, assesses the patient and initiates the supportive treatment. The details of victim are reported back to the trauma center which keeps the required things ready for prompt reception and definitive treatment of the patient which is started as soon as the patient is received in the center
A trauma service is led by a team of trauma surgeons, including such specialists as neurosurgeons and orthopedic surgeons. A trauma center will often have a helipad for receiving patients.
Trauma centers are classified into four levels depending upon their capacity and capability.
This changes the whole approach to trauma.
India lacks trauma centers and integrated trauma care in true sense. But things must change in future to impart better trauma services.
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