The DGU trauma network
By Professor Steffen Ruchholtz MD, (below) Chairman of the Department of Trauma, Hand and Reconstructive Surgery at University Hospital Giessen and Marburg GmbH
German pre-clinical and clinical trauma care of severely injured people enjoys an excellent reputation nationally and internationally due to the country's intensive work in trauma surgery and related medical disciplines. Nevertheless, it should be pointed out that the current outcome of polytrauma care in Germany is extremely heterogeneous.
• The catchment areas of the individual hospitals differ markedly in the Federal States: 4634 km2 in Mecklenburg-Vorpommern and 541 km2 in North Rhine-Westphalia. Similar differences apply to the area covered per medical helicopter and the size of the regional road grid.
• The different care classifications, organisation, staff availability, infrastructure and material resources of the hospitals participating in polytrauma care vary significantly.
In view of these differences, in 2004 the DGU launched the Traumanetzwerk initiative, which aims to raise the quality of polytrauma care to a single, high level throughout Germany
Local trauma network structures between supraregional and regional trauma centres and basic trauma surgery aim to ensure that every seriously injured patient is taken to the shock room of a suitable or even certified hospital within a 30-minute drive from the accident site.
The White Paper on trauma care for severely injured persons (Weissbuch der Schwerverletztenversorgung) published by the DGU in 2006, demands the following:
• Defined criteria for the admission of accident victims from the site to a trauma centre or facility offering basic trauma surgery.
• Implementation of harmonised staff, infrastructural and organisational preconditions (e.g. shock room).
• Standardised treatment paths and transfer criteria for the early phases of trauma care for severely injured patients, according to the evidence-bases DGU guidelines (e.g. DGU guideline S3).
• Harmonisation of medical qualifications by joint training programmes (e.g. ATLS. www.atls.de).
• Participation in external and internal quality assurance programmes and collection of current care figures and workflow on the basis of the DGU trauma register (www.traumaregister.de).
• Implementation of telecommunication systems that enable participating hospitals to coordinate the further care path in or immediately after the acute treatment phase.
Currently, more than 500 hospitals, forming 56 regional trauma networks, are registered in the certification process (www.dgu-traumanetzwerk.de).
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