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1、CHAPTER18MANAGEMENTOFACUTETRAUMAR.ShaynMartinandJ.WayneMerediththeInjuredPatient,whichisusedextensivelybytraumacentersoverviewandhistory1worldwide.TheCOTalsohasdevelopedtheNationalTraumatraumasystemsDataBank(NTDB),whichisthelargestdatabaseoftraumainjuryscoringpatientsinexistence,currentlyincludingov
2、er3millionpatientsprehospitaltraumacarefrom567traumacenters.JustastheCOTwascommissionedinitialassessmentandmanagementbytheACSatthenationallevel,ithasalsoformedindividualmanagementofspecificinjuriescommitteesontraumaatthestatelevelthatworkundertherehabilitationdirectionofthenationalcommittee.Thisstru
3、cturehasproventobepowerfulbyallowingmanyoftheendeavorsthatadvancethecareoftheinjuredpatienttooccuratthestatelevel,becauseleadershipinfrastructureandpoliticsdifferregionally.Activitiesofthestatecommitteesfrequentlyincludetraumasystemdevel-OVERVIEWANDHISTORYopmentwiththecreationoftriagedocuments,maxim
4、izingtheTreatmentoftheinjuredpatienthasbeenapredominantmissionuseofprehospitalandhospitalresources,injurypreventionini-ofthesurgeonsincetheoriginofmedicalcare.Fewothersurgi-tiatives,maintenanceofstatewidetraumaregistries,andadvance-caldisciplinesincorporatesuchawiderangeofskillsasthosementofperforma
5、nceimprovementefforts.Frequently,amajorrequiredbythesurgeonwhoismanagingsevereinjury.Thepartofthisworkistheongoingpursuitofreliablefundingtreatmentofinjuriespredatesrecordedhistory,withevidenceofmechanismstopayfortheimprovementintraumacarethrough-neurosurgicalproceduresdiscoveredfromapproximately10,
6、000outthestate.WithintheinfrastructureofthenationalCOT,BC.Althoughthescienceofimprovinghowinjuriesaremanagedstatesarealsogroupedintoregions,whichallowsforthesharingprogressescontinuously,ithasbeenduringwartimethatmanyofinformationpertainingtosuccessfulstatewideinitiativesandofthegreatestadvancements
7、wereachievedbecauseofthehighthediscussionofissuesinvolvingborderingstates.burdenofinjuryduringtheserelativelyshortperiods.Box18-1Severalotherorganizationshavebeenformed,withthelistssomemajorcontributi
