However, there are downsides to massive trauma systems with ‘scoop and run’ approach.Rapid transit to hospital remains the standard of care.A result of the concept is the preference for a ‘scoop and run’ approach to prehospital care rather than “stay and play” - so that patient’s are transferred to hospital for definitive care as soon as possible.
An analogous concept, the “platinum 10 minutes” places a time constraint on the pre-hospital care of seriously injured patients: no patient should have more than 10 min of scene-time stabilization by the prehospital team prior to transport to definitive care at a trauma centre.The validity of this concept remains controversial.Adams Cowley, founder of Baltimore’s renowned Shock Trauma Institute, who in a 1975 article stated, “the first hour after injury will largely determine a critically injured person’s chances for survival” – this was in an era characterised by a lack of an organised trauma system and inadequate prehospital care. The term “golden hour” is widely attributed to R.Optimal early management may prevent theseĪs with most things that are ‘classic’, whether this schema matches reality is highly questionable (see Wyatt et al, 1995 Demetriades et al, 2005 Gunst et al, 2010)….Usually due to multi-organ failure or sepsis.ATLS style emergency care specifically targets these patients.Usually unpreventable eg: apnoea secondary to high spinal or brain injury, or catastrophic hemorrhage due to great vessel disruption.Trauma deaths are classically described as having a trimodal distribution: Most preventable deaths are due to hemorrhage.There is a massive additional societal burden from morbidity affecting survivors as well.It is also a major killer of older age groups, behind cardiovascular disease and cancer. Trauma is the leading cause of death under the age of 40 years in developed countries. The ‘golden hour’ is term often used in trauma to suggest that an injured patient has 60 minutes from time of injury to receive definitive care, after which morbidity and mortality significantly increase.Trauma deaths are classically described as having a trimodal pattern (this is controversial).Trauma is a major cause of morbidity and mortality, especially in the
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