The American Medical Experts recently published a story that discusses the standards of “trauma care.” Most might not be familiar with this term. In essence it refers to medical treatment provided in unique situations, most notably military surgeons in combat.
The actual principles of medical care are the same for all medical patients–the body does not differ between soldiers and civilians. However, the general “best practices” or “rules of the road”for surgeons differ, depending on the situation. It does not take much imagination to consider that aiding an injured soldier in the heat of combat on the battlefield is far different than performing a scheduled surgery in an modern hospital. Obviously any claims of “malpractice” would be different in each situation. The trauma care doctor has a wide range of pressures, timing issues, and logistical challenges that the traditional doctor does not.
But as the AME article discusses, the past century of trauma care has actually influenced the care provided in regular hospitals. This is most notably in the ways that trauma care protocols have developed over the past 100 years. The United States Army Surgical Research Institute uses official “trauma guidelines.” They were apparently developed (and are refined) in conjunction with the American College of Surgeons Committee on Trauma. The refinement is made both with medical advances as well as following surveys which indicate what works and what doesn’t. Obviously the goal is always to act in the most efficient way to improve the outcome for the patient.
While trauma care on the battlefields in Iraq and Afghanistan are clearly different than traditional hospital care, there are some similarities. Most notably, when a patient is rushed into an emergency room, the need to act quickly and minimize the harm. In that regard, much can be learned from trauma care–in the so-called “golden” hour (the critical period immediately after an injury). Using the lessons from trauma care may work to minimize adverse outcomes that are common in these cases–damage to limb functioning, blood infections, sepsis, and more.
In fact, the article makes clear that failure to abide by the standard guidelines in these situations is medical malpractice. It is important to reiterate what that means. The guidelines discussed here are simply very basic steps that should always be taken: ensuring the patient’s airways are unobstructed, ensuring breathing, and providing circulation. The article notes that too many doctors miss those “ABCs” in trauma situations, because they immediately focus on the direct injury itself (i.e. a gunshot wound).
But “forgetting” in that setting is unacceptable. The reason that they are considered standards is because systematic studies and research have shown unequivocally that following those steps leads to the best patient outcomes. It is not a matter of mere different approaches to an unscientific process–it represents following the science itself.
It is important for all patients and their families in a trauma care situation–even if not an actual battlefield to understand these general principles. All medical patients deserve a certain standard of care, it doesn’t matter what the injury is or where it occurs.
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