This book is a quick guide to the key components of trauma center administration, management, and patient care. This book provides essential information for hospitals working toward trauma center designation, and for established trauma centers who want to improve their performance. This book provides trauma center personnel with a comprehensive overview of trauma center administrative structure, basic clinical operations, performance improvement and site visit preparation and examines the most common critical injuries seen by trauma centers to demonstrate how a properly functioning center addresses multiple priorities in critically ill patients. This book provides critical information for hospitals looking toward becoming a trauma center and established trauma centers that wants to improve their performance.
This book offers an overview of acute care surgery around the world, focusing on the four main branches of this novel subdiscipline: trauma, general emergencies, critical care, and rescue surgery. The book’s primary goal is to provide a general view of acute care surgery, while addressing the most important issues in depth. The content is divided into three parts, the first of which is dedicated to the general organization of trauma centers, including the composition of modern trauma teams. Protocols of activation and action for the trauma team, as well as damage control procedures both in the emergency room and in the surgical theatre, are described. The book also addresses the development of a trauma registry, together with the quality assessment process that can be applied. In turn, the second part describes the principal protocols for making diagnoses, with special attention to circumstances such as unstable hemodynamics, neurological deterioration, normal vital signs, and penetrating injuries. The book subsequently deals with the most important aspects of trauma to the abdomen, chest, and pelvis, with notes on both surgical and intensive care issues. Practical descriptions of how to treat principal injuries to various organs are also provided. Finally, the third part of the book is dedicated to the most frequent general surgical emergencies and rescue surgical approaches, and includes information on diagnostic support with point of care ultrasound and endoscopic advanced techniques. Presenting cutting-edge strategies, this book will be of interest to professionals involved in surgical and intensive care for emergency conditions, such as colonic perforations, obstructions, acute pancreatitis, biliary tree stones, and caustic injuries.
Early Thoughts on Creating Comprehensive Trauma Centers This volume has been many years in writing. When Dr. Donald Meichenbaum first suggested it and I approached my coauthor Lasse Nurmi, it did not seem to be as formidable a task as it has become. Interviewing the centers in this book has taken years-to get responses, to summarize those responses, and to return the summaries for further comment. Many centers have been created in that time; others have suspended operation. This volume does not claim to present even a majority of those centers. However, the ones contained herein are representative of "what is out there. " The idea to create a comprehensive trauma center is not new. The initial section of this forward examines thoughts I proposed as part of my compre hensive examination for my doctorate. Many of the ideas proposed then (1989) seem to fit now. It is my dream to put them into practice someday in the future. THE COMPREHENSIVE EXAMINATION QUESTION In 1989, one question on the written comprehensive examination ques tions for my doctorate was, "If you were to create a comprehensive trauma center in your suburban area, making use of what you have learned in your [doctoral] experience, describe the organization of that center, the mission, structure, personnel, funding, objectives, and services it would offer. " Some of the conclusions reached then now seem applicable to the task at hand: design ing comprehensive trauma centers (CTCs) for the 21st century.
Here are gripping true-life stories of emergency medical response teams who every day face split-second decisions--and one false move can mean the difference between life and death.
Managing a trauma center involves complex clinical care, long nights and days, administrative work, self-examination, critical review of patient care and significant regulatory requirements. Performance improvement is the key element of trauma center effectiveness. No trauma center provides flawless care, thus all centers have opportunities to improve. A competent performance improvement program is critical to trauma center outcomes. This book provides key information on all aspects of trauma PI and program management. In some ways, PI is an art more than a science, so the more interaction program leaders have with strong PI programs, the more they can learn about how to improve their processes. The book outlines the generally accepted processes for identification of opportunities for improvement, which are the key component of performance improvement. This includes: rounding with care teams, contemporaneous chart review, audit filters, and voluntary submissions to the trauma program for review. This book explains how to triage opportunities for improvement, analyze them, form corrective actions, and finally achieve loop closure. The book covers the roles of the personnel in the PI program, what is required to dissect the opportunity to determine action plans, how to document the entire process, and how to keep track of opportunities for improvement to ensure that your program is progressively improving care. The final sections of the book deal with specific opportunities for improvement, action plans, and loop closure through the use of case studies. The book serves as a follow-up to Dr. Jeffrey Young’s recently published book Trauma Centers, which serves as a quick guide to the key components of trauma center administration, management, and patient care.
Produced by a world-renowned team of trauma specialists, this source reviews initial management considerations beginning in the pre-hospital phase, continues through the primary and secondary surveys of the hospital-based evaluation process, and proceeds to the perioperative management of trauma, burns, and associated conditions. This reference pro
Advances in trauma care have accelerated over the past decade, spurred by the significant burden of injury from the wars in Afghanistan and Iraq. Between 2005 and 2013, the case fatality rate for United States service members injured in Afghanistan decreased by nearly 50 percent, despite an increase in the severity of injury among U.S. troops during the same period of time. But as the war in Afghanistan ends, knowledge and advances in trauma care developed by the Department of Defense (DoD) over the past decade from experiences in Afghanistan and Iraq may be lost. This would have implications for the quality of trauma care both within the DoD and in the civilian setting, where adoption of military advances in trauma care has become increasingly common and necessary to improve the response to multiple civilian casualty events. Intentional steps to codify and harvest the lessons learned within the military's trauma system are needed to ensure a ready military medical force for future combat and to prevent death from survivable injuries in both military and civilian systems. This will require partnership across military and civilian sectors and a sustained commitment from trauma system leaders at all levels to assure that the necessary knowledge and tools are not lost. A National Trauma Care System defines the components of a learning health system necessary to enable continued improvement in trauma care in both the civilian and the military sectors. This report provides recommendations to ensure that lessons learned over the past decade from the military's experiences in Afghanistan and Iraq are sustained and built upon for future combat operations and translated into the U.S. civilian system.
