Development of trauma systems in Europe-reports from England, Germany, the Netherlands, and Spain

Tim Js Chesser; Chris Moran; Keith Willett; Bertil Bouillon; Johannes Sturm; Sascha Flohé; Steffen Ruchholtz; Suzan Dijkink; Inger B Schipper; Juan Carlos Rubio-Suarez; Francisco Chana; Julio de Caso; Enrique Guerado

doi:10.1097/OI9.0000000000000019

Development of trauma systems in Europe-reports from England, Germany, the Netherlands, and Spain

OTA Int. 2023 Sep 1;2(Suppl 1):e019. doi: 10.1097/OI9.0000000000000019. eCollection 2019 Mar.

Authors

Affiliations

¹ Department of Trauma and Orthopaedics, North Bristol NHS Trust, Bristol.
² National Clinical Director for Trauma, Professor of Orthopaedic Trauma Surgery, Nottingham University Hospitals NHS Trust, Nottingham.
³ National Director for Acute Care to NHS England, Professor of Orthopaedic Trauma Surgery, University of Oxford, Oxford, UK.
⁴ Department of Trauma and Orthopaedic Surgery, University of Witten/Herdecke, Cologne Merheim Medical Center, Cologne, Germany.
⁵ AUC-Akademie der Unfallchirurgie, Berlin.
⁶ Department of Trauma and Orthopaedic Surgery, City Hospital Solingen.
⁷ Department of Trauma and Orthopaedic Surgery, University Hospital Marburg Germany.
⁸ Department of Trauma Surgery, Leiden University Medical Center, Leiden, The Netherlands.
⁹ Hospital Universitario La Paz. University Autonoma of Madrid.
¹⁰ Hospital Universitario Gregorio Marañon. University Complutense of Madrid, Madrid.
¹¹ Hospital Universitario Santa Creu i Sant Pau. University Autonoma of Barcelona Barcelona.
¹² Professor and Chairman Department of Orthopaedic Surgery and Traumatology, Hospital Universitario Costa del Sol. University of Malaga. Marbella Malaga, Spain.

Abstract

Major trauma systems have evolved in many European countries and have resulted in improved care in terms of mortality and morbidity. Many of the systems have similar history, with reports of either poor services, or a single disaster, driving change of policy and set up. We report on 4 European systems, looking at the background, set up and some of the results. Similar issues are identified including the importance of triage, the concentration of specialist skills which require patients to bypass hospitals, and the standardization of treatment protocols. The issues of rehabilitation and the increasing importance of measuring outcome with patient reported metrics are discussed.

Keywords: major trauma systems.