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Abstract
Scandinavian countries face common challenges in trauma care. It has been suggested
that Scandinavian trauma system development is immature compared to that of other
regions. We wanted to assess the current status of Scandinavian trauma management
and system development.
An extensive search of the Medline/Pubmed, EMBASE and SweMed+ databases was conducted.
Wide coverage was prioritized over systematic search strategies. Scandinavian publications
from the last decade pertaining to trauma epidemiology, trauma systems and early trauma
management were included.
The incidence of severe injury ranged from 30 to 52 per 100,000 inhabitants annually,
with about 90% due to blunt trauma. Parts of Scandinavia are sparsely populated with
long pre-hospital distances. In accordance with other European countries, pre-hospital
physicians are widely employed and studies indicate that this practice imparts a survival
benefit to trauma patients. More than 200 Scandinavian hospitals receive injured patients,
increasingly via multidisciplinary trauma teams. Challenges remain concerning pre-hospital
identification of the severely injured. Improved triage allows for a better match
between patient needs and the level of resources available. Trauma management is threatened
by the increasing sub-specialisation of professions and institutions. Scandinavian
research is leading the development of team- and simulation-based trauma training.
Several pan-Scandinavian efforts have facilitated research and provided guidelines
for clinical management.
Scandinavian trauma research is characterised by an active collaboration across countries.
The current challenges require a focus on the role of traumatology within an increasingly
fragmented health care system. Regional networks of predictable and accountable pre-
and in-hospital resources are needed for efficient trauma systems. Successful development
requires both novel research and scientific assessment of imported principles of trauma
care.
(c) 2009 Elsevier Ltd. All rights reserved.