Strategic proposal for a national trauma system in France

Abstract

In this road map for trauma in France, we focus on the main challenges for system implementation, surgical and radiology training and upon innovative training techniques. Regarding system organisation: procedures for triage, designation and certification of trauma centres are mandatory to implement trauma networks on a national scale. Data collection with registries must be created, with a core dataset defined and applied through all registries. Regarding surgical and radiology training, diagnostic-imaging processes should be standardised and the role of the interventional radiologist within the trauma team and the trauma network should be clearly defined. Education in surgery for trauma is crucial and recent changes in medical training in France will promote trauma surgery as a specific sub-specialty. Innovative training techniques should be implemented and be based on common objectives, scenarios and evaluation, so as to improve individual and team performances. The group formulated 14 proposals that should help to structure and improve major trauma management in France over the next 10 years.

Effect of under triage on early mortality after major pediatric trauma: a registry-based propensity score matching analysis

“…Author details 1 RENAU Northern French Alps Emergency Network, Public Health Department, Annecy Hospital, F-74000 Annecy, France. 2 Grenoble Alps Trauma Center, Department of Anesthesiology and Intensive Care Medicine, Grenoble University Hospital, F-38000 Grenoble, France. 3 Department of Pediatric Care, Pediatric Intensive Care Unit, Grenoble University Hospital, F-38000 Grenoble, France.…”

“…The implementation of trauma systems has been advocated worldwide to reduce mortality after severe trauma [1]. These systems rely on designated trauma centers and standardized field triage to provide appropriate care according to the patient's needs [2]. Field triage protocols aim for the lowest under triage possible, i.e., the admission of a severely injured patient to a non-specialized trauma center [3].…”

Epidemiology of trauma in France: mortality and risk factors based on a national medico-administrative database

“…In industrialised countries, trauma remains a challenge for the organisation of pre-hospital systems including the triage of patients between different hospitals. In France, a group of experts [5] recently suggested a strategic proposal for a national trauma system. At variance with other countries [6], no registry being available, the epidemiology of trauma patients was never described at a large scale [7,8].…”

The laborious structuring of traumatology in France

“…Emergency physicians, intensivists and surgeons have recently shown pronounced determination to set up a nationwide care network and register for trauma patients. The foundations for this type of organization have been clearly drawn up 5 . A robust commitment of the surgery community in view of promoting a network and a nationwide trauma patient register will not only accelerate their elaboration, but also enable us to play a key role in development of their architecture.…”