Abstract
From a global perspective, it is estimated that nearly six million people per year die from traumatic injury and millions more are left with significant disability. Trauma accounts for approximately 10% of the world's deaths and is 32% greater in number than tuberculosis, malaria, and HIV/AIDs combined. Concerningly, approximately 90% of these deaths occur in low resource settings. With a standardized, teachable approach and skills, the authors believe that there is great potential for improvement and establishing trauma care equity in low resource settings. The emphasis of this chapter is not to replace formal trauma resuscitation training, but to highlight the nuances of low-resource trauma care, gaps in care equity, and identify actionable items to improve initial trauma care.
TopA Systems Based Approach To Resuscitation
Trauma-systems are defined as integrated health systems that provide organized, coordinated efforts in a defined geographic area to serve injured patients. (American Trauma Society, 2004) Scene safety is the first step in a trauma system response and this is of the utmost importance in the pre-hospital, austere, and low resource environments. In the United States and other developed countries, EMS infrastructure addresses this with data gathering from a central dispatch operator. The National Highway and Traffic Safety Administration teaches EMTs scene safety priorities in a specific order; 1) personal safety, 2) safety of their partners or colleagues, and 3) care of the patient). Any danger to one must be addressed prior to moving forward in the algorithm. In LMIC trauma-emergency response, lacking organization and infrastructure introduces new risk to the people responding to emergencies. The collaboration with weather scientists and radar data can help mitigate safety issues when responding during volatile weather dynamics; local authorities, fire-response teams, and military forces can aid in providing physical safety when providing care in conflict zones or hazmat exposures. (Klein, 2021)
Key Terms in this Chapter
Specialist: A healthcare provider who specializes in a particular area of medicine or surgery; often not available to rural or remote areas in LMICs.
Low-Middle-Income country (LMIC): Countries that have $1,005 to $3,995 gross national income per capita; typically spending less than $100 USD per capita on healthcare and its subsequent systems.
Trauma Systems: Programs in place to aid in the prevention, treatment, and rehabilitation of traumatized patients.
Health Disparity: Identified areas of inequality in access or provision of healthcare to a population.
Trauma Care Equity: The access and quality of trauma related care provided to a population is equal across countries.
Austere Medicine: The practice of medicine without standard modern resources outside of organized, structured hospital systems.
General Practitioner: A healthcare provider with basic skills working in LMICs.