Helling Thomas S
Department of Surgery, University of Missouri-Kansas City School of Medicine, USA.
Mo Med. 2003 Sep-Oct;100(5):510-4.
Trauma occurring in the rural setting presents a unique set of challenges not found in more populated areas. Risk of death is distinctly increased, probably as a result of prehospital factors such as delayed recognition and inconsistency of EMS response and care. Lack of trauma trained physicians and hospital resources also contribute to a higher death rate. Development and designation of rural trauma centers can be instrumental in reversing this trend. The education in trauma care that goes hand-in-hand with designation is probably most responsible for better outcomes of trauma patients. The guiding philosophy in such a system should be one of 'minimal acceptable care' with early recognition of major trauma and expeditious transfer of these patients. This does not obviate the responsibility of rural trauma centers to deal quickly and effectively with patients in whom ongoing blood loss is an immediate threat to life and to exert a damage control approach as an initial phase of treatment.
农村地区发生的创伤带来了一系列在人口密集地区所没有的独特挑战。死亡风险明显增加，这可能是由于院前因素，如识别延迟以及紧急医疗服务（EMS）反应和护理的不一致。缺乏受过创伤培训的医生和医院资源也导致了更高的死亡率。农村创伤中心的发展和指定有助于扭转这一趋势。与指定相伴的创伤护理教育可能是创伤患者获得更好治疗结果的最主要原因。这种系统的指导理念应该是“最低可接受护理”，即早期识别重大创伤并迅速转运这些患者。这并不免除农村创伤中心迅速有效地处理持续失血对生命构成直接威胁的患者，并在治疗的初始阶段采取损害控制方法的责任。
