The integrated trauma service concept.

An integrated trauma service, through coordination of pre-existing manpower and resources, insures the availability of medical care to patients suffering unforeseen or critical physical injuries and their sequelae. Provided an examination of the overall emergency medical service capabilities of the community dictates the need for a trauma service, the first step is to secure a surgeon interested in the care of the trauma patient. Cooperation of physician colleagues is gained by a policy of mandatory consultation whenever injuries involve specialty areas. Trauma service involvement begins with prioritization, resuscitation, and assessment of the patient in the emergency department and extends through definitive care, management of injury sequelae and rehabilitation. The "isolated injury" is defined by the trauma service and the appropriate specialty service notified. Injuries involving two or more body systems dictate admission to the trauma service except for the patient with an unstable cervical spine injury or deteriorating neurologic status. Under such circumstances, a neurosurgical admission is instituted and the trauma service consults. When the trauma service is operational, educational programs, data collection and retrieval, and follow-up care are enhanced.