Trauma and trauma treatment is an ancient medical problem, but also a medical problem in modern civilized society. With the development of social economy, accidental injuries and traffic accidents occur frequently, and the kinetic energy of injury factors increases significantly, and the proportion of severe trauma and multiple injuries increases significantly. According to statistics, nearly 1.3 million people are killed and 50 million injured due to road traffic injuries in the world every year. Trauma is already second only to cardiovascular diseases and tumors, ranking the fourth among the causes of death in the population, and the first among the causes of death among people under the age of 40. The potential years of life lost after injury and the impact on social productivity exceed other diseases. Trauma has become a social problem.
The truly organized and systematic development of trauma treatment and trauma research began in the 1930s. The early trauma care model was subspecialty: traditionally, the first surgical treatment of any surgical disease was the priority time for definitive repair or reconstruction, but the persistent fatality rate of severely traumatized patients gradually led people to realize that the cause of death was not the cause of death. Surgery failed, but secondary to trauma and post-operative internal environment disturbance, physiological dysfunction, and eventually the triad of trauma death—hypothermia, coagulation dysfunction, and acidosis. The concept of damage control (DC) is New strategies for the treatment of severe trauma and polytrauma emerge as the times require. The DC concept has changed the concept that patients with severe trauma must undergo definitive surgery in the first operation, and pays more attention to temporary life-saving after trauma and control of pathophysiological changes. In the past 20 years, scholars at home and abroad have paid great attention to the application of DC in the treatment of severe trauma, from theory to practice, so as to improve the treatment level of patients with severe trauma.
In recent years, the level of trauma treatment, especially the treatment of multiple trauma, has been rapidly improved with the continuous progress of basic research, surgical techniques, and default instruments and materials, and the principles and methods of trauma treatment have been constantly updated and reformed. The first is the update of the treatment model. It is determined that physicians with multidisciplinary knowledge are responsible for the whole process of emergency inspection and evaluation, emergency surgery, ICU resuscitation, and definitive surgery after stabilization. This is called the "integrated standard model". The second is the update of treatment techniques and theories: damage control focuses on overall rescue and treatment, regards surgery as a part of overall recovery, and avoids second-strike injuries caused by improper treatment.
In 2011, the leaders of the hospital took a far-sighted view, systematically managed the emergency department and the critical trauma department, and established a trauma emergency and multi-trauma treatment system. The establishment of this system marks the extension of the concept of first aid to pre-hospital first aid, which is directly in line with the international advanced trauma and critically ill first aid model, forming an "integrated" first aid model, shortening the response time of critically ill and traumatized first aid, and truly realizing the The seamless connection of green life channels from outside the hospital to the inside of the hospital. An expert group on the "Green Channel for Emergency and Critical Care Rescue" was established with the vice president as the general coordinator and medical personnel with the deputy senior title or above in the relevant departments. Severe multiple trauma treatment, severe brain trauma treatment group, severe peripheral nerve injury treatment group, severe thoracic and abdominal organ trauma treatment group, and severe medical basic disease treatment group were established. The general coordinator will coordinate and organize the implementation of the "Green Channel for Emergency and Critical Care Rescue". The emergency duty personnel are on duty for 24 hours, and the duty personnel of each professional group will arrive at the emergency department within 5 minutes to assess the condition, and promptly notify the relevant treatment team members according to the characteristics of the injury. Go directly to the designated location (CT room or operating room, etc.).
As one of the important links in the hospital's emergency green channel, the critical trauma department shortens the time from admission to surgery for severely traumatized patients to less than 50 minutes. In 2012, nearly 1,000 patients with multiple injuries were treated, including more than 160 severe cases, and the success rate of rescue More than 92%, reaching the domestic advanced level. The critical trauma department adopts a group treatment mode. The physicians in the group have different professional expertise, ensuring that each patient with multiple injuries will receive the overall treatment of physicians with expertise in first aid, orthopedics, and surgery at the same time.
At present, the critical trauma department has become a comprehensive team with 6 ICU beds, 30 treatment beds and nearly 40 medical staff. There are 3 master students in the department, and the talent structure is reasonable. Director Chu Haibin presided over the overall work of the department, part-time youth member of the Disaster Professional Committee of the Chinese Association of Integrative Medicine, member of the trauma treatment expert group, editorial board member of "Chinese Health Emergency" magazine, part-time associate professor of Shandong University of Traditional Chinese Medicine, and member of the Emergency Physician Branch of Shandong Medical Doctor Association. , Member of the Intensive Care Physician Branch of Shandong Medical Association, Deputy Director of the Intensive Care Professional Committee of Weihai Medical Association, and member of the Weihai Orthopaedic Society. Ju Chuanbao, deputy director of clinical work for more than 20 years, is a member of Weihai Orthopaedic Society, and vice chairman of Weihai Medical Association Enteral and Parenteral Nutrition Professional Committee. Deputy Director Yin Zegang is in charge of intensive care work. He is also a member of the Shandong Provincial Collateral Disease Professional Committee and a member of the Weihai Medical Association Enteral and Parenteral Nutrition Professional Committee. Head Nurse Zhang Jing is in charge of general nursing work, and Deputy Head Nurse Yao Haijing is in charge of intensive care unit nursing work. The department has modern emergency treatment equipment such as ventilator, defibrillator, bedside hemofiltration, bronchoscopy, etc., providing timely and effective emergency treatment for trauma and critically ill patients.
In recent years, the trauma emergency and multiple injury treatment system has flourished under the direct care of the hospital leaders, participated in the preparation of 10 medical monographs and more than 30 medical papers, and 6 doctors and 10 nurses obtained professional qualifications through examinations. Certificate, more than 20 people went to domestic excellent hospitals to study trauma surgery, emergency medicine, neurosurgery, critical care nursing, etc. In 2012, emergency department, critical trauma department, and intensive care unit, as emergency disciplines, became key specialized construction units of traditional Chinese medicine in Shandong Province. It is one of the few emergency departments in the traditional Chinese medicine system. At present, the department has developed into a comprehensive trauma emergency center featuring severe multiple injuries and critical trauma treatment, taking a leading position in this field.
