Goals of the Essential Trauma Care Project

In working towards decreasing the burden of death and disability from injury, a spectrum of activities needs to be considered, ranging from surveillance and basic research to prevention programmes, to trauma management. Large gains are to be made in prevention, and hence a major emphasis should be placed on this approach. There are also major gains to be made by addressing treatment. That is to say, low-cost initiatives can help to reinforce current trauma treatment systems worldwide and by so doing help to reduce the overall burden from injury. The goals of the Essential Trauma Care (EsTC) Project are to identify and promote such inexpensive ways of reinforcing trauma treatment worldwide.

The EsTC Project seeks to accomplish this overall goal by better defining what essential trauma treatment services should realistically be made available to almost every injured person worldwide.The project then seeks to develop ways of assuring the availability of these services by reinforcing inputs of: (1) human resources (training and staffing); and (2) physical resources (supplies and equipment). These inputs are outlined in the form of a template, referred to as the EsTC resource matrix. It is intended that this template and the entire manual should be used as a guide for those planning trauma treatment services for their countries or areas.

The following chapter is intended as an introduction to the concept and development of the EsTC Project. It outlines the current disparities in outcome between persons injured in high-income countries and those injured in low- and middle-income countries. It briefly reviews some of the difficulties facing trauma care in developing countries which may account for existing disparities and which are the focus of efforts to improve organization and reinforce services. It reviews the foundations we have on which to build in our efforts to improve trauma treatment services, including essential health service programmes for other diseases and efforts to improve trauma care in individual countries. It introduces the premise that improvements in the organization of trauma treatment services may represent a cost-effective way of improving the delivery and outcome of such services, and presents evidence to this effect. It then summarizes the process by which this manual was developed and written, and suggests how it should ultimately be used. Finally, it addresses the overlap between the EsTC Project and other international health activities, including WHO activities.

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