bypass - transport of an EMS patient past a normally
used EMS receiving facility to a designated medical facility for the
purpose of accessing more readily available or appropriate medical care
citizen access - the act of requesting emergency assistance
for a specific event
communications system - a collection of individual
communication networks, a transmission system, relay stations, and control
and base stations capable of interconnection and interoperation that
are designed to form an integral whole. The individual components must
serve a common purpose, be technically compatible, employ common procedures,
respond to control, and operate in unison.
Critical Access Hospital (CAH)- a rural limited service
hospital that has been converted to a special designation as a Critical
Access Hospital under the Medicare Rural Hospital Flexibility Grant Program.
The majority of CAHs are in Health Professional Shortage Areas and/or
Medically Underserved Areas.
designation - formal recognition of hospitals as providers
of specialized services to meet the needs of the severely injured patient;
usually involves a contractual relationship and is based on adherence
to standards
disaster - any occurrence that causes damage, ecological
destruction, loss of human lives, or deterioration of health and health
services on a scale sufficient to warrant an extraordinary response from
outside the affected community area
dispatch - coordination of emergency resources in
response to a specific event
emergency medical services for children (EMS-C) -
an arrangement of personnel, facilities and equipment for the effective
and coordinated delivery of emergency health services to infants and
children that is fully integrated within the emergency medical system
of which it is a part
emergency medical services system (EMS) - a system
that provides for the arrangement of personnel, facilities, and equipment
for the effective and coordinated delivery of health care services in
appropriate geographical areas under emergency conditions
field categorization (classification) - a medical
emergency classification procedure for patients that is applicable under
conditions encountered at the site of a medical emergency
inclusive trauma care system - a trauma care system
that incorporates every health care facility in a community in a system
in order to provide a continuum of services for all injured persons who
require care in an acute care facility; in such a system, the injured
patient's needs are matched to the appropriate hospital resources
injury - the result of an act that damages, harms,
or hurts; unintentional or intentional damage to the body resulting from
acute exposure to thermal, mechanical, electrical or chemical energy
or from the absence of such essentials as heat or oxygen
injury control - the scientific approach to injury
that includes analysis, data acquisition, identification of problem injuries
in high risk groups, option analysis and implementing and evaluating
countermeasures
injury prevention - efforts to forestall or prevent
events that might result in injuries
injury rate - a statistical measure describing the
number of injuries expected to occur in a defined number of people (usually
100,000) within a defined period (usually 1 year). Used as an expression
of the relative risk of different injuries or groups
lead agency - an organization that serves as the focal
point for program development on the local, regional or state level
major trauma - that subset of injuries that encompasses
the patient with or at risk for the most severe or critical types of
injury and therefore requires a systems approach in order to save life
and limb
mechanism of injury - the source of forces that produce
mechanical deformations and physiologic responses that cause an anatomic
lesion or functional change in humans
medical control - physician direction over prehospital
activities to ensure efficient and proficient trauma triage, transportation,
and care, as well as ongoing quality management morbidity - the relative
incidence of disease
mortality rate - the proportion of deaths to population
off-line medical direction - the establishment and
monitoring of all medical components of an EMS system, including protocols,
standing orders, education programs, and the quality and delivery of
on-line control
on-line medical direction - immediate medical direction
to prehospital personnel in remote locations (also know as direct medical
control) provided by a physician or an authorized communications resource
person under the direction of a physician
overtriage - directing patients to trauma centers
when they do not need such specialized care. Overtriage occurs because
of incorrect identification of patients as having severe injuries when
retrospective analysis indicates minor injuries.
protocols - standards for EMS practice in a variety
of situations within the EMS system
quality improvement - a method of evaluating and improving
processes of patient care which emphasizes a multidisciplinary approach
to problem solving, and focuses not on individuals, but systems of patient
care which might be the cause of variations
quality management - a broad term which encompasses
both quality assurance and quality improvement, describing a program
of evaluating the quality of care using a variety of methodologies and
techniques
regionalization - the identification of available
resources within a given geographic area, and coordination of services
to meet the needs of a specific group of patients
rehabilitation - services that seek to return a trauma
patent to the fullest physical, psychological, social, vocational, and
educational level of functioning of which he or she is capable, consistent
with physiological or anatomical impairments and environmental limitations
response time - the time lapse between when an emergency
response unit is dispatched and arrives at the scene of the emergency
risk factor - a characteristic that has been statistically
demonstrated to be associated with (although not necessarily the direct
cause of) a particular injury. Risk factors can be used for targeting
preventative efforts at groups who may be particularly in danger of injury.
rural - those areas not designated as metropolitan
statistical areas (MSAs)
service area (catchment area) - that geographic area
defined by the local EMS agency in its trauma care system plan as the
area served by a designated trauma center
specialty care facility - an acute care facility that
provides specialized services and specially trained personnel to care
for a specific portion of the injured population, such as pediatric,
burn injury, or spinal cord injury patients
surveillance - the ongoing and systematic collection,
analysis, and interpretation of health data in the process of describing
and monitoring a health event
trauma - a term derived from the Greek for "wound";
it refers to any bodily injury (see injury)
trauma care system - an organized approach to treating
patients with acute injuries; it provides dedicated (available 24 hours
a day) personnel, facilities, and equipment for effective and coordinated
trauma care in an appropriate geographical region
Trauma Care Systems Planning and Development Act of 1990 -
The law that amended the Public Health Service Act to add Title XII -
Trauma Programs. The purpose of the legislation is to assist State governments
in developing, implementing and improving regional systems of trauma
care, and to fund research and demonstration projects to improve rural
EMS and trauma
trauma center - a specialized hospital facility distinguished
by the immediate availability of specialized surgeons, physician specialists,
anesthesiologists, nurses, and resuscitation and life support equipment
on a 24 hour basis to care for severely injured patients or those at
risk for severe injury
trauma registry - a collection of data on patients
who receive hospital care for certain types of injuries. Such data are
primarily designed to ensure quality trauma care and outcomes in individual
institutions and trauma systems, but have the secondary purpose of providing
useful data for the surveillance of injury morbidity and mortality
trauma team - the multidisciplinary group of professionals
who have been designated to collectively render care for trauma patients
in a particular trauma care system
triage - the process of sorting injured patients on
the basis of the actual or perceived degree of injury and assigning them
to the most effective and efficient regional care resources, in order
to insure optimal care and the best chance of survival
triage criteria - measures or methods of assessing
the severity of a person's injuries that are used for patient evaluation,
especially in the prehospital setting, and that use anatomic and physiologic
considerations-and mechanism of injury
uncompensated care - care for which no reimbursement
is made
undertriage - directing fewer patients to trauma centers
than is warranted because of incorrect identification of patients as
having minor injuries when retrospective analysis indicates severe injuries
9-1-1 - a three-digit telephone number to facilitate
the reporting of an incident or situation requiring response by a public
safety agency
enhanced 9-1-1 - a telephone system that includes
automatic number identification, automatic location identification, and
(optimally) selective routing, to facilitate appropriate public safety
response