Imolementing pedestrian safetv interventions <br />Attachment C <br />Attachment B <br />guidelines in treating the injured has shown to improve patient survival (S6). Training <br />health care staff involved in care of the injured in such protocols is important, and is <br />a mandatory requirement in many countries. Major trauma resuscitation should be <br />a team effort where each trained team member has a designated role in management <br />of the patient. Such trauma teams have been shown to lead to significant reductions <br />in resuscitation times (S7). Improvements in hospital-based care do not necessarily <br />require expensive technology or equipment. Trauma care can also be achieved in an <br />affordable and sustainable way by imparting training, better organization, planning <br />and simple quality improvement programmes (S8). <br />Rehabilitation <br />Many of those who survive injuries are left with physical disabilities that limit their <br />mobility and function (see Box 4.10). Many of these consequences are avoidable and <br />can be minimized by early, multi-disciplinary rehabilitation services. Rehabilitation <br />services are an essential element of trauma care and should be made available to <br />those who need them. There is an increasing trend to offer all the above services to <br />the injured in an integrated manner, through an inclusive trauma system, which is a <br />comprehensive injury response network that includes all facilities with capabilities <br />to care for the injured. For example, the United States has a vision of a future trauma <br />system that is intended to enhance community health through an organized system <br />of injury prevention, acute care and rehabilitation that is fully integrated with the <br />public health system in a community. It is anticipated that trauma systems will <br />possess the ability to identify risk factors and related interventions to prevent injuries <br />in a community, and will maximize the integrated delivery of optimal resources for <br />patients who ultimately need acute trauma care. It is hoped that trauma systems will <br />address the daily demand of trauma care and form the basis for disaster preparedness. <br />The resources required for each component of a trauma system will be clearly <br />identified, deployed and studied to ensure that all injured patients gain access to the <br />appropriate level of care in a timely, coordinated and cost-effective manner (Sy). <br />Countries should also be prepared to deal with those who are injured by reducing <br />their consequences and enhancing their quality of life. The way in which injured <br />pedestrians are dealt with following a road traffic crash determines their chances and <br />the quality of survival. The three components of care outlined above - pre-hospital, <br />hospital and rehabilitation - are interrelated and form a chain of care. <br />88 <br />Page 234 <br />