1. سیستم تروما (سامانه حوادث)

2. سیستم تروما (سامانه حوادث) پیش بیمارستان درمان تریاژ انتقال (مدیریت – ارتباطات)

3. سیستم تروما (سامانه حوادث) مراقبت حاد مرکز تروما (آمادگی 24 ساعته) سطح مورد نیاز پیش بیمارستان درمان تریاژ انتقال (مدیریت – ارتباطات)

4. سیستم تروما (سامانه حوادث) بازتوانی (نو توانی) مراقبت حاد مرکز تروما (آمادگی 24 ساعته) سطح مورد نیاز پیش بیمارستان درمان تریاژ انتقال (مدیریت – ارتباطات)

5. Phases of Trauma Care Prehospital care Emergency Departments and Trauma Centers Rehabilitation Facilities

7. Prehospital Care Triage decision scheme to determine best level of care required Initiation of care based on protocols Attempt to stabilize patient Rapid transport

8. Emergency Departments Variable levels of equipment, training, and capabilities, from tertiary hospitals to very small community hospitals All responsible for initiation of management ATLS designed primarily as a regimented, prioritized approach to trauma care (in particular for survival in small center with little staff) Interhospital agreements to care for injuries beyond resources

9. Trauma Center Hospital that meets certain readiness requirements for care of injured persons Categorized by level (usually 1 through 4) by capacity/capability Involves having the right personnel and equipment readily available for trauma care

10. Trauma Centers Committed resources dedicated to caring for trauma patients – Level I tertiary, 24 h a day trauma attending – Level II community, not as comprehensive – Level III community, fewer resources – Level IV rural, stabilize and transfer

11. Specialty Trauma Centers Pediatric Trauma Burn Spinal Cord Injury Hand Rehabilitation

12. Advanced Trauma Life Support (ATLS) Systematic, prioritized approach to trauma care Guidelines for even non trauma center providers to effectively manage trauma patients until patient can get to definitive care

13. ATLS – The Primary Survey Simple ABC’s Approach – Airway with cervical protection – Breathing – Circulation – Disability – Exposure and environmental control

14. RESOURCE CONSUMPTION Rehabilitation Moderate Injuries Severe Injuries Minor Injuries Prevention SEVERITY Prehospital Care Acute Care SERVICE VOLUME A MODEL TRAUMA SYSTEM OTHER ACUTE CARE FACILITIESLEVEL IIILEVEL IILEVEL I Field Triage Activation 85% 15% Exclusive System Inclusive System TRANSFERS TRAUMA SYSTEMS

15. 2006 86% of major trauma patients lived 1995 75% of major trauma patients lived Trauma Outcomes Have Improved Dramatically Since 1995

16. A trauma SYSTEM is a statewide system of care that includes all providers: prehospital, hospital and rehab A trauma CENTER is a hospital that meets certain requirements for the excellent care of trauma patients. Trauma centers are a part of a trauma system.

17. Thank You ! American College of Surgeons COMMITTEE ON TRAUMA Consultation Program for Trauma Systems