ABSTRACT
Worldwide, injuries have become a major cause of morbidity and mortality. Early care of the injured can help reduce the disability from injuries. Emergency trauma care has become a major specialty in most major hospitals. However, there is wide gap in the access and availability of care for the injured until he reaches a hospital. Pre-hospital care of the injured has evolved significantly over the years and has almost become synonymous with advances in Ambulance
Planning and
based transportation of the injured. Several technical interventions are done from the site of the injury until the patient reaches a definitive care facility. Many of these have been adopted as consensus based interventions and not really based on evidence based medicine. Research in this area has been challenging because of the multiplicity of agencies involved, the urgent nature of the problem with the randomization of multiple tasks done in the pre-hospital setting, and changes from traditional protocols are difficult, not only for research but also for ethical reasons. However, looking at the issues that are controversial there is a need to do serious research on outcome studies in this area. By and large, it seems in urban areas where access to care is easier and possible in less than an hour, we do not need to do too much other than safely transporting the patient to a definitive care facility. This chapter looks at some of the components of prehospital care, and discusses some of the key areas of controversy.
