Current concepts in trauma: 1. Principles and directions for development.

Despite considerable advances in treatment in the last 20 years, trauma continues to be the main cause of disability and death for people under the age of 40 years. The outcome after injury has been improved by the introduction of advanced prehospital life support, early transfer and the establishment of specialized programs. Trauma care is governed by two underlying principles: early definitive management and a continuum of treatment from the time of injury to the return to the activities of daily life. Most important, a team approach is necessary in the treatment of the trauma patient. This requires the cooperation and participation of prehospital emergency personnel and referring hospitals as well as multidisciplinary collaboration within each trauma centre. There continue to be areas of neglect that prevent optimal trauma care and must be addressed.