Regionalisation of trauma care in Germany: the “TraumaNetwork DGU®-Project”

Ruchholtz, Steffen; Mand, Carsten; Lewan, Ulrike; Debus, Florian; Dankowski, Catrin; Kühne, C.; Siebert, H.

doi:10.1007/s00068-011-0166-6

Cited by 21 publications

(14 citation statements)

References 23 publications

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“…The TraumaNetwork DGU 1 in Germany is a strong clinical, educational, and economic cooperation of hospitals with different levels of competence in one region. The major goal is to ensure competent, highquality, multidisciplinary care for every severely injured patient, even outside of the centers [21,30]. Through 2012, 595 hospitals in 37 networks have been certified by an independent organization.…”

Section: Discussionmentioning

confidence: 99%

“…Most accidents occur in August and September in Germany [30]. Most accidents happen between 3 and 6 pm in both countries [24,39] (Table 2).…”

Section: Vehicular Infrastructure and Causes Of Road Traffic Accidentmentioning

confidence: 99%

“…They are linked into a network of usually 10 to 15 neighboring hospitals. Furthermore, agreements between the trauma centers and the prehospital rescue systems regulate the admission and transfer of patients in a trauma network (TraumaNetwork DGU 1 ) [30].…”

Section: Prehospital Care In Germanymentioning

confidence: 99%

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Trauma Care in India and Germany

Oestern¹,

Garg

Kotwal

2013

Clinical Orthopaedics &Amp; Related Research

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Background Road traffic accidents are among the leading causes of death worldwide in individuals younger than 45 years. In both India and Germany, there has been an increase in registered motor vehicles over the last decades. However, while the number of traffic accident victims steadily dropped in Germany, there has been a sustained increase in India. We analyze this considering the sustained differences in rescue and trauma system status. Questions/purposes We compared India and Germany in terms of (1) vehicular infrastructure and causes of road traffic accident-related trauma, (2) burden of trauma, and (3) current trauma care and prevention, and (4) based on these observations, we suggested how India and other countries can enhance trauma care and prevention.

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Section: Discussionmentioning

confidence: 99%

“…Most accidents occur in August and September in Germany [30]. Most accidents happen between 3 and 6 pm in both countries [24,39] (Table 2).…”

Section: Vehicular Infrastructure and Causes Of Road Traffic Accidentmentioning

confidence: 99%

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Trauma Care in India and Germany

Oestern¹,

Garg

Kotwal

2013

Clinical Orthopaedics &Amp; Related Research

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“…At that time the German Trauma Society decided to go one step further and initiated the TraumaNetzwerk DGU 1 . The aim was to establish a nation wide comprehensive trauma system in order to maintain or improve the quality of trauma care by improving communication and establishing standards of care [5,6]. Designated trauma centres were audited and certified every three years.…”

mentioning

confidence: 99%

Preface

Bouillon¹,

Hoffmann²,

Siebert³

et al. 2014

Injury

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“…The German TraumaNetwork DGU® Project was initiated in 2006 to improve the pre-hospital rescue system of seriously injured patients, to accelerate their transfer to an appropriate hospital and to compensate for variations in the hospital infrastructure, personal strength and equipment [1]. Dividing the participating hospitals into local, regional and supra-regional trauma surgical centres, this new quality emergency system reached full coverage throughout Germany in 2012.…”

Section: Introductionmentioning

confidence: 99%

Utilisation of Blood Components in Trauma Surgery: A Single-Centre, Retrospective Analysis before and after the Implementation of an Educative PBM Initiative

Geissler

Kösters

Franz

et al. 2015

Transfus Med Hemother

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Background: The aim of our single-centre retrospective study presented here is to further analyse the utilisation of allogeneic blood components within a 5-year observation period (2009-2013) in trauma surgery (15,457 patients) under the measures of an educational patient blood management (PBM) initiative. Methods: After the implementation of the PBM initiative in January 2012, the Institute of Transfusion Medicine und Transplantation Immunology educates surgeons and nurses at the Department of Trauma Surgery to avoid unnecessary blood transfusions. A standardised reporting system was used to document the utilisation of blood components carefully for the most frequent diagnoses and surgical interventions in trauma surgery. These measures served as basis for the implementation of an interdisciplinary systematic exchange of information to foster decision-making processes in favour of patient blood management. Results: Since January 2012, the proportion of patients who received a transfusion as well as the number of transfused red blood cell (RBC) (7.3%/6.4%; p = 0.02), fresh frozen plasma (FFP) (1.7%/1.3%; p < 0.05) and platelet (PLT) (1.0%/0.5%; p < 0.001) units were reduced as a result of our PBM initiative. However, among the transfused patients, the number of administered RBC, FFP and PLT units did not decrease significantly. Overall, patients who did not receive transfusions were younger than transfused patients (p = 0.001). The subgroup with the highest probability of blood transfusion administered included patients with intensive care and long-term ventilation (before/after implementation of PBM: RBC 81.5%/75.9%; FFP 33.3%/20.4%; PLT 24.1%/13.0%). Only a total of 60 patients of 531 patients suffering multiple traumas were massively transfused (before/after implementation of PBM: RBC 55.6%/49.8%; FFP 28.4%/20.4%; PLT 17.6%/8.9%). Conclusion: According to our educational PBM initiative, at least the proportion of trauma patients who received allogeneic blood transfusions could be reduced significantly. However, in case of blood transfusions, the total consumption of RBC, FFP and PLT units remained stable in both time periods. This phenomenon might indicate that the actual need of blood transfusions rather depends on the severity of trauma-related blood loss, the coagulopathy rates or the complexity of the surgical intervention which mainly determines the intra-operative blood loss. Taken together, educational training sessions and systematic reporting systems are suitable measures to avoid unnecessary allogeneic blood transfusions and to continuously improve their restrictive application.

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Regionalisation of trauma care in Germany: the “TraumaNetwork DGU®-Project”

Cited by 21 publications

References 23 publications

Trauma Care in India and Germany

Trauma Care in India and Germany

Preface

Utilisation of Blood Components in Trauma Surgery: A Single-Centre, Retrospective Analysis before and after the Implementation of an Educative PBM Initiative

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