1. Rapid triage, assessment, resuscitation, stabilization and transfer of the critically injured patient

2.  Rapid accurate assessment  Resuscitate and stabilize by priority  Determine needs and capabilities  Arrange for transfer to definitive care  Assure optimum care

3.  Demonstrate concepts/principles of primary and secondary assessment  Establish management priorities  Initiate primary/secondary management  Demonstrate the skills necessary to assess/manage the critically injured patient

4.  Trauma is the leading cause of death in the first 4 decades of life in most developing countries  3.8 million deaths/year worldwide  312 million injured/year worldwide

6.  “When I can provide better care in the field with limited resources than what my children and I received at the primary care facility…there is something wrong with the system and the system has to be changed.”

7. Immediate Early Late

8.  ABCDE-approach to evaluation/treatment  Treat greatest threat to life first  Definitive diagnosis NOT immediately important  Time is of the essence  Do no further harm

9. Airway with c-spine protection Breathing/ventilation/oxygenation Circulation: stop the bleeding Disability Expose/environment/body temperature

10. Injury Primary survey Resuscitation Reevaluation Secondary survey Reevaluation Optimize patient Transfer

11.  May include: ◦ Interactive lectures and skills sessions ◦ Demonstrations ◦ Group discussions ◦ Simulated patient scenarios ◦ Written exams

12.  Documented improvements in care of injured patient after implementation of program  Decreased injury mortality  Lower per capita injury death  Retention of organizational and procedural skills

13.  ABCDE approach to trauma care  One, safe way  Do no further harm  Treat the greatest threat to life first