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Tue Nov 21 13:12:27 GMT 2006

At least ONE role of a trained trauma surgeon in these circumstances
might be to lead an effort at systematized care across the culture.  Of
course this requires that one not only be a trained trauma surgeon, but
an energetic and visionary (Mattoxian) leader.  

Once true leadership inspires even rudimentary systematization, the work
of trained trauma surgeons everywhere becomes easier and more rewarding.

I'm short on time and caffeine, and rather distracted; but here's a list
of recommendations, probably incomplete and surely in no particular
order (in trauma systems development, there is no particular order.
Most initiatives depend on other initiatives.  Linear implementation is
impossible).

1: Seek out other healthcare and political leaders.  Buy them lunch and
talk about trauma.  Enlist their participation in your vision.  You're
gonna need their help.
2: Articulate the need for special attention to trauma as a distinct
disease.
3: Quantify the problem (as best as possible) in terms of M&M, financial
cost, and dedication of resources.  Don't get bogged down in detail
until you have the fat numbers.  How many patients are there?  What is
their survival rate?  What are the most common mechanisms and injuries?
Where (geographically) are they injured, and where do (should) they end
up?
3: Identify measurable objectives and standards you may use to track
performance of the system.
4: Develop population based injury prevention plans, and press for their
implementation.
5: Facilitate training across the professional spectrum, bearing in mind
that in very real terms, prehospital and nursing proficiency save at
least as many lives as a trained trauma surgeon.  An hour's time with
volunteer ambulance attendants may have twice the impact of a two-day
ATLS course.
6: Always bear in mind that the great systems are the simplest ones.
Start with basic concepts, like out-of-hospital intervals and
destination criteria.  Likely as not, you'll find ideas like these have
a huge impact at little cost.  And you'll inspire others to work the
system with you.

Best of luck.

Pret Bjorn, RN
Bangor, ME USA

-----Original Message-----
From: trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org] On Behalf Of sandeep jain
Sent: Tuesday, November 21, 2006 2:19 AM
To: trauma-list at trauma.org
Subject: role of trauma surgeon

can I get ideas about the role of trained trauma
surgeon in a developing country with economic
restraints. all hospitals have full fledged general
surgeons,orthopedic surgeons,plastic,vascular and
neurosurgeons along with emergency physicians already
looking after trauma.

sandeep

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