O'Connor Robert E
Christiana Health Care System, Newark, DE, USA.
Prehosp Emerg Care. 2006 Jul-Sep;10(3):343-6. doi: 10.1080/10903120600728847.
The fundamental tenet of a trauma system is to get the right patient to the right hospital at the right time. Although most injuries are minor or moderate and can be managed at local community hospitals, a significant minority of injured patients require extensive and expensive care to survive or minimize injury. Most prehospital trauma triage criteria address a combination of factors to consider, but this approach sometimes fails to identify patients with severe injuries and often burdens trauma centers with patients suffering minor injuries. It is critical to utilize a method to differentiate those injury victims who need the specialized expertise and resources available in trauma centers from those who can be adequately cared for locally. Although trauma centers assume the leadership role, in a truly inclusive system, all health care providers (prehospital, community hospitals, and trauma centers) have a defined role in providing care to patients with trauma. All these institutions should establish and maintain transfer agreements for the transfer of patients meeting system trauma triage criteria. Because prehospital triage criteria are not 100% sensitive, there should be a mechanism in place for the secondary triage of patients. Initial management of patients should continue while efforts are made to transfer the patient.
创伤系统的基本原则是在正确的时间将合适的患者送到合适的医院。虽然大多数损伤为轻度或中度，可在当地社区医院处理，但有相当一部分受伤患者需要广泛且昂贵的治疗才能存活或将损伤降至最低。大多数院前创伤分诊标准涉及多种需要考虑的因素，但这种方法有时无法识别重伤患者，还常常让创伤中心负担处理轻伤患者的工作。利用一种方法区分那些需要创伤中心提供的专业知识和资源的受伤患者与那些可在当地得到充分治疗的患者至关重要。虽然创伤中心承担领导作用，但在一个真正包容性的系统中，所有医疗服务提供者（院前、社区医院和创伤中心）在为创伤患者提供治疗方面都有明确的角色。所有这些机构都应制定并维持关于转运符合系统创伤分诊标准患者的转运协议。由于院前分诊标准并非100%敏感，因此应建立对患者进行二次分诊的机制。在努力转运患者的同时，应继续对患者进行初始处理。
