Diagnosis and management of major trauma.

A regional trauma system involving trained hospital teams as well as physician-manned ambulances and helicopters has been established in Norway. Emphasis is on written guidelines and the continuous evaluation of the results. A grading system of injury severity is used. Despite major advances in the initial treatment of shock and major trauma, posttraumatic pulmonary insufficiency still represents a problem. Our results indicate a beneficial effect of the early prophylactic use of high-dose corticosteroids in major chest trauma. The use of three doses of methylprednisolone was not associated with any increased risk of infection.