Sharma B R
Department of Forensic Medicine and Toxicology, Government Medical College and Hospital, Chandigarh-160 030, India.
J Clin Forensic Med. 2005 Apr;12(2):64-73. doi: 10.1016/j.jcfm.2005.01.006. Epub 2005 Mar 16.
Trauma is a significant cause of death and suffering in society and there is strong evidence that mortality and morbidity may be reduced by provision of effective medical care through a trauma care system. It is reasonable to believe that severely injured patients should be transported as quickly as possible to a center where definitive medical care is possible. Conversely, it is also an argument that the resources of a trauma center must not be overwhelmed by assessment and treatment of minor trauma for patients who could be reasonably expected to do well with care in a clinic or a primary care hospital. Triage was developed to sort out those most likely to survive and to need medical care. Many triage tools have been developed and evaluated. However, the goal in setting triage criteria to provide a protocol for properly categorising injured patients, transporting them to appropriate hospitals, and ensuring an appropriate response to all trauma patients is yet to be achieved. Whatever the reasons and rate of failure due to different reasons, it is not unusual to read the reports wherein the quality of care becomes suspect in an increasingly litigious society. This paper examines the evolution of triage systems in trauma care from a forensic viewpoint.
创伤是社会中导致死亡和痛苦的一个重要原因,有确凿证据表明,通过创伤护理系统提供有效的医疗护理可以降低死亡率和发病率。有理由相信,重伤患者应尽快被送往能够提供确定性医疗护理的中心。相反,也有一种观点认为,对于那些在诊所或初级保健医院接受护理有望康复的患者,创伤中心的资源不应因对轻伤患者的评估和治疗而不堪重负。分诊的目的是筛选出最有可能存活且需要医疗护理的患者。已经开发并评估了许多分诊工具。然而,制定分诊标准以提供一个对受伤患者进行正确分类、将他们送往合适医院并确保对所有创伤患者做出适当反应的方案这一目标尚未实现。无论由于何种原因以及不同原因导致的失败率如何,在一个诉讼日益增多的社会中,读到关于护理质量受到质疑的报告并不罕见。本文从法医学角度审视创伤护理中分诊系统的演变。