Care of Trauma Patients: In-hospital Phase

  • A. De Monte
  • G. Nardi


The chain for survival of trauma patients includes several links: identification, notification, first aid on the scene, safe prehospital transportation, diagnostic procedures, treatment of life-threatening lesions first and definitive stabilisation of trauma injuries later, until hospital discharge. The strength of the chain is given by its weakest link and therefore each single passage of this survival chain has to “run” at its fastest speed but synchronising with the others. For example, all the advantages of an efficient and top level prehospital care might be nulified by a less efficient in-hospital working phase.


Trauma Patient Emergency Medical Service Trauma Care Trauma System Definitive Stabilisation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    American College of Surgeons Committee on Trauma (1991) Advanced Trauma Life Support Course Student Manual. American College of Surgeons, ChicagoGoogle Scholar
  2. 2.
    Skinner D, Drisco U P, Earlam R (eds) (1991) ABC of major trauma. Br Med JGoogle Scholar
  3. 3.
    De Monte A, Nardi G (1994) Protocolli ATLS per il trattamento del politrauma. In: Associazione di pubblica assistenza (ed) Testo ufficiale Corso Nazionale di Emergenza VTLS, SignaGoogle Scholar
  4. 4.
    Clemmer PT, Orme FJ, Thomas OF et al (1985) Outcome of critically injured patients treated at level I trauma centres versus full-service community hospitals. Crit Care Med 13:861–863PubMedCrossRefGoogle Scholar
  5. 5.
    Shackford RS, Mackersie CR, Hoyt BD et al (1987) Impact of a trauma system on outcome of severely injured patients. Arch Surg 122:523–527PubMedCrossRefGoogle Scholar
  6. 6.
    Eastman BA, Lewis RF, Champion RH, Mattox LK (1987) Regional trauma system design: critical concepts. Am J Surg 154:79–87PubMedCrossRefGoogle Scholar
  7. 7.
    West GJ, Wilhams JM, Trunkey DD, Wolferth CC (1988) Trauma systems. Current status-future challenges. JAMA 259:3597–3600PubMedCrossRefGoogle Scholar
  8. 8.
    Maull IK, Schwab WC, McHenry DS et al (1986) Trauma center verification. J Trauma 26: 521–524PubMedCrossRefGoogle Scholar
  9. 9.
    Ornato PJ, Craren JE, Nelson MN, Kimball FK (1985) Impact of improved emergency medical services and emergency trauma care on the reduction in mortality from trauma. J Trauma 25:575–579PubMedCrossRefGoogle Scholar
  10. 10.
    Gibson G (1978) Categorization of hospital emergency capabilities: some empirical methods to evaluate appropriateness of emergency department utilization. J Trauma 18:94–102PubMedCrossRefGoogle Scholar
  11. 11.
    Mesnick P (1991) Emergency medical services, trauma care, and disaster planning. In: Capan ML (ed) Trauma: anesthesia and intensive care. Lippincott, Philadelphia, pp 845–859Google Scholar
  12. 12.
    Hurst MJ (1991) Trauma: an overview. In: Rippe MJ (ed) Intensive care medicine. Little, Brown, Boston, pp 1455–1458Google Scholar
  13. 13.
    Wilson FW (1989) Trauma. In: Shoemaker CW (ed) Textbook of critical care. Saunders, Philadelphia, pp 1230–1271Google Scholar
  14. 14.
    National Research Council (1966) Accidental death and disability: the neglected disease of modern society. Washington DCGoogle Scholar
  15. 15.
    Shackford RS, Hollingworth-Fridlung P, Cooper FG, Eastman BA (1986) The effect of régionalisation upon the quality of trauma care as assessed by concurrent audit before and after institution of a trauma system: a preliminary report. J Trauma 26:812–820PubMedCrossRefGoogle Scholar
  16. 16.
    Eggold R (1983) Trauma care régionalisation: a necessity. J Trauma 23:260–262PubMedCrossRefGoogle Scholar
  17. 17.
    Ammons AM, Moore EE, Pons TP et al (1988) The role of a regional trauma system in the management of a mass disaster: an analysis of the Keystone, Colorado chairlift accident. J Trauma 28:1468–1471PubMedCrossRefGoogle Scholar
  18. 18.
    Trunkey DD, Blaisdell WF (1988) Epidemiology of trauma. In: Wilmore WD (ed) Care of the surgical patient. Scientific Am IV;6:l-7Google Scholar
  19. 19.
    De Monte A, Nardi G, Giordano F et al (1995) Il pohtraumatizzato dal primo soccorso al ricovero in terapia intensiva. Fase intraospedaliera. In: Pasetto (ed) Le nuove frontiere dell’impegno anestesiologico: il sistema di emergenza, i trapianti e la terapia antalgica domiciliare. Atti del convegno, pp 34–37Google Scholar

Copyright information

© Springer-Verlag Italia, Milano 1996

Authors and Affiliations

  • A. De Monte
  • G. Nardi

There are no affiliations available

Personalised recommendations