Biomedical Engineering and Emergency Medicine, University of Virginia Health System, Charlottesville, VA, USA.
J Environ Pathol Toxicol Oncol. 2010;29(4):271-91. doi: 10.1615/jenvironpatholtoxicoloncol.v29.i4.20.
In this manuscript, I will outline three specific evolutionary achievements in the delivery of emergency and trauma care, followed by caveats on what prevents an emergency and trauma system from achieving optimal goals and maintaining them. First, I will review the emergence of the specialty of emergency medicine under the guidance of Dr. James Mills, and outline the steps he took to establish the specialty in acute care hospitals. Second, I will discuss the heroic career of Dr. R Adams Cowley, a cardiothoracic surgeon who took some of the principles of cardiac resuscitation and surgery and rapid military evacuation of the wounded from the battlefield, and applied them to the resuscitation and transport of the severely injured trauma patient to a fully prepared and equipped trauma center, and also created an organized approach to trauma care in Maryland. Third, I will provide an overview of the subsequent development of a comprehensive emergency medical system in the Commonwealth of Virginia. Finally, I will emphasize what prevents good public health policy regarding emergency medical and trauma care, and some of the changes that must be made to ensure that the Commonwealth of Virginia and other states provide optimal care for their citizens through their emergency medical care and trauma systems.
在本文中，我将概述在紧急和创伤护理方面的三个具体的进化成就，然后再讨论是什么因素阻止了紧急和创伤系统实现最佳目标并保持这些目标。首先，我将回顾在詹姆斯·米尔斯博士的指导下，急诊医学专业的出现，并概述他在急性护理医院建立该专业所采取的步骤。其次，我将讨论心胸外科医生 R·亚当斯·考利博士的英勇事迹，他从战场上将心脏复苏和手术的一些原则以及伤员的快速军事撤离应用于严重创伤患者的复苏和转运到准备充分和设备齐全的创伤中心，并在马里兰州创建了一个有组织的创伤护理方法。第三，我将概述弗吉尼亚州全面紧急医疗系统的后续发展。最后，我将强调是什么因素阻止了有关紧急医疗和创伤护理的良好公共卫生政策，以及必须进行哪些改变，以确保弗吉尼亚州和其他州通过其紧急医疗和创伤系统为其公民提供最佳护理。
