Mock Charles, Arreola-Risa Carlos, Quansah Robert
Harborview Injury Prevention and Research Center, Box 359960, 325 Ninth Avenue, Seattle, WA 98104, USA.
Inj Control Saf Promot. 2003 Mar-Jun;10(1-2):45-51. doi: 10.1076/icsp.10.1.45.14114.
In all countries, the priority for reducing road traffic injuries should be prevention. Nonetheless, there are low-cost ways to strengthen the care of injured persons, that will help to lower the toll from road traffic. The purpose of this review was to elucidate ways to accomplish this goal in the context of less developed countries. Studies selected for this review were obtained by Medline review, selecting on key words such as trauma, injury, trauma care, essential health services, and developing country. Articles pertaining to any country and all available years were considered. In addition, the authors utilized articles from the gray literature and journals from Mexico and Ghana that are not Medline referenced. Studies surveyed point to road safety and other forms of injury prevention, as well as prehospital care, as likely priorities for developing countries. Nonetheless, hospital-based improvements can contribute to decreases in mortality and, especially, decreases in disability. For both prehospital and hospital based care, studies revealed several critical weak points to address in: (1) human resources (staffing and training); (2) physical resources (equipment, supplies, and infrastructure); and (3) administration and organization. The 'essential services' approach, which has contributed to progress in a variety of fields of international health, needs to be developed for the care of the injured. This would define the trauma treatment services that could realistically be made available to virtually every injured person. It would then address the inputs of human resources, physical resources, and administration necessary to assure these services optimally in the different geographic and socioeconomic environments worldwide. Finally, it would identify and target deficiencies in these inputs that need to be strengthened.
在所有国家，减少道路交通伤害的首要任务都应是预防。然而，仍有一些低成本方法可加强对伤者的救治，这将有助于降低道路交通伤亡人数。本综述的目的是阐明在欠发达国家背景下实现这一目标的方法。本次综述所选研究通过医学文献数据库（Medline）检索获得，检索关键词包括创伤、损伤、创伤护理、基本卫生服务和发展中国家。考虑了与任何国家及所有可用年份相关的文章。此外，作者还利用了灰色文献以及墨西哥和加纳未被医学文献数据库收录的期刊上的文章。所调查的研究指出，道路安全和其他形式的伤害预防以及院前护理可能是发展中国家的优先事项。尽管如此，基于医院的改进措施有助于降低死亡率，尤其是减少残疾率。对于院前和医院护理，研究揭示了在以下方面需要解决的几个关键薄弱环节：（1）人力资源（人员配备和培训）；（2）物质资源（设备、物资和基础设施）；（3）管理和组织。在国际卫生的各个领域都取得了进展的“基本服务”方法，需要针对伤者护理进行发展。这将界定实际上可为每一位伤者提供的创伤治疗服务。然后，它将解决在全球不同地理和社会经济环境中以最佳方式确保这些服务所需的人力资源、物质资源和管理投入。最后，它将识别并针对这些投入中需要加强的不足之处。
