The Director General of Public Health, Ildefonso Hernandez, presented the protocol / guide actions and good practices in the initial care of traffic accident (TA) in a conference on this matter which was attended by over 300 professionals. Participated in the presentation also general director of Traffic, Pere Navarro, deputy director general of Civil Protection SAMUR, Ervigio Corral.
This document is a first step in establishing a general framework for integrated action on this assistance. Poses the ideal scenario that should lay the emergency medical services, both in information systems, coordination and management as well as assistance to traffic accident.
In developing this protocol have involved professionals who perform their work in the emergency medical services in nine regions, which has expanded the perspective on the different characteristics of each. He has also had the support of technicians from the ministries of Health, Social Affairs and Equality, and Interior.
traffic injuries are a public health issue requiring a multisectoral approach. Preventing such injuries is a responsibility shared by all. Once the occurrence of the accident, every effort should be addressed to limit the severity of the trauma and suffering causes, to prevent deaths and prevent disabilities and, finally, to achieve optimal evolution of survivors and their reintegration into the community.
addition to prevention, we need the coordinated sequence of actions that begins with witnesses or persons who discovered the accident, which play an important role in continuing with the rescue of those injured by the emergency services and medical emergency , and culminates in the treatment of injuries and rehabilitation.
IMPROVE ROUGH TIME
This document is a first step in establishing a general framework for integrated action on this assistance. Poses the ideal scenario that should lay the emergency medical services, both in information systems, coordination and management as well as assistance to traffic accident.
In developing this protocol have involved professionals who perform their work in the emergency medical services in nine regions, which has expanded the perspective on the different characteristics of each. He has also had the support of technicians from the ministries of Health, Social Affairs and Equality, and Interior.
traffic injuries are a public health issue requiring a multisectoral approach. Preventing such injuries is a responsibility shared by all. Once the occurrence of the accident, every effort should be addressed to limit the severity of the trauma and suffering causes, to prevent deaths and prevent disabilities and, finally, to achieve optimal evolution of survivors and their reintegration into the community.
addition to prevention, we need the coordinated sequence of actions that begins with witnesses or persons who discovered the accident, which play an important role in continuing with the rescue of those injured by the emergency services and medical emergency , and culminates in the treatment of injuries and rehabilitation.
IMPROVE ROUGH TIME
The different actors involved in the accident detection traffic and subsequent health care can contribute to improving service times bumpy. This assertion is based on the concept of "golden hour", coined by Dr. Adams Crowley, a military surgeon and director of the Care Center of Maryland shock trauma. Dr. Crowley said "There is a golden hour between life and death. If you are seriously injured, you have less than 60 minutes to survive. You can not die then, but I can do three days or two weeks later, because something has happened in your body that is irreparable. "
Mortality in accidents Traffic has, from the point of view of time, a characteristic phase distribution:
* Phase 1. Occurs in the first few seconds or minutes after the accident, representing 10% of all deaths due to severe injuries or breakage Central Nervous System of the great arteries. It is very difficult or almost impossible to prevent these deaths.
* Phase 2. The so-called "golden hour", as often happens in the first or second hour after the accident. Constitutes the highest mortality (75%). The deaths, at this stage are mainly due to obstructions airway or loss of circulating volume. Is the phase in which they can avoid the higher rate of deaths through early appropriate health care, time and training.
* Phase 3. Occurs days or weeks after the traumatic incident. Tend to generate 15% of total mortality. Is usually due to complications after initial treatment (multiorgan failure, postoperative complications, etc.). They take a big effort and a lot of resources to reduce mortality in this phase.
This consideration also affects morbidity (sickness) of the lesions. The aftermath can be more and more a function of the delay in providing assistance and care in the final resolution in the hospital. Thus, the time factor is an essential element throughout the care process.
CENTER USEFUL TOOL FOR THERAPY
CENTER USEFUL TOOL FOR THERAPY
Each of the processes in the initial care of the victim has different temporal duration. Begins with the notification of the incident by the citizen or institution arousal, and ends with the transfer of the patient receiving hospital or Useful Center. " In addition, you should add the time spent in the hospital until the application of the so-called "useful therapy, surgery in most patients traumatized by accident. In all processes must be noted that this is a time-dependent disease, in which all care decisions should take into account the chronological parameter.
Various studies in both Europe and the U.S. have shown that the provision of health care for the victims of AT, especially the severe patients (1.5%) is essential to reduce the severity of those between 15% and 50% of cases. This assistance goes to have an adequate emergency medical service to provide early care and "in situ" the patient, and a network of hospitals with adequate capacity to serve these patients (so-called "Trauma Center" .) It has been shown that the transfer of multiple trauma patients led to useful sites, and not to the nearest hospital can be a decrease in mortality up to 15%.
OPTIMUM SCENARIO IN THE EMERGENCY RESPONSE
The process of emergency care for accidents trafficking involves multiple factors and, above all, an optimal setting to enable quality care to the injured. An optimal scenario must satisfy at least the following circumstances:
- A central communications with a single access number, known by all citizens, to respond with minimal delay to any emergency.
- A medical emergency service that gives adequate coverage in response times to the area of \u200b\u200bcompetence.
- The existence of health professionals trained in health care units to ensure advanced life support care to injured patients. There are procedures
- operational and health care that enable the same quality care, regardless of their carers.
- Existence of a protocol for coordination with referral hospitals, enabling a continuity of care without delay or duplication of diagnosis and treatment.
- Existence of a system of collecting data on traffic accidents attended.
ANNEX
This conference aims to discover this Protocol or Guide recommendations for improving the process of providing initial health care in traffic accidents all involved. It is a first step in establishing a general framework for integrated action on this assistance, raising an ideal scenario that should lay the emergency medical services, both in information systems, coordination, management and assistance to traffic accident.
This chapter covers the following:
1. Education and Training: a school population, general public, first responder and health personnel
2. Call Management: What is a communications center and a focal point of health. Personal and responsibilities. How should you manage a call? (Interrogation, first councils, making decisions for the activation and mobilization of resources) and accidents with multiple victims. Quality criteria and recommendations.
3. Network resources: This chapter provides a number of technical criteria to enable the Health Services of the Autonomous Communities have a tool to size the network of resources both human and material, to provide an adequate response and optimal victims in an AT .
4. Operating procedures and assistance in caring for AT: Describe all actions taken by health professionals, both on site and during transport and transfer to more appropriate health center, where you will receive definitive treatment of his injuries.
5. Shared information network: records. Discusses the various sources of information and proposes the creation of a network in which information can be shared key generated by the emergency services.
6. Indicators of effectiveness of emergency services in the AT: Need for indicators common quality to all emergency services. Is a set of indicators that evaluate the different processes, call receiving centers, operational capacity of the emergency system, the quality of care and, ultimately, the overall system efficiency. 
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