Trauma System Development Program

on 20 November, 2012

The increasing number of trauma victims in Ecuador ignited our interest in this field, which constitutes one of the relegated problems in public health in our nation.

In collaboration with the International Trauma System Development Program (ITSDP) of Virginia Commonwealth University (VCU) we are involved in the creation and execution of a pilot project in trauma in the Amazon province of Morona Santiago to improve the care of injured patients.

After an initial assessment of the area’s statistics, resources, needs and deficiencies, it was clear that a true trauma system was lacking along with major shortcomings in the medical community for handling trauma victims. There was enormous variability and inaccuracy of local and national statistics. In spite of this an injured patient pathway was revealed.

The next step was to work on education of frontline physicians by developing a hands-on Basic Trauma Course tailored specifically to the region, taking into account local resources and expertise. 


Image 1: Hands-on trauma training for physicians 

The results of the initial site assessment and first Basic Trauma Course were presented at the 89th American College of Surgeons meeting in New Orleans in October 2004. We had 52 participants, which included 33 rural physicians, 7 general practice residents, 11 senior medical students and 1 nurse administrator. There was a significant improvement in knowledge of the participants based on pre and post course tests.

A second Basic Trauma Course for physicians and a first Course for pre-hospital personnel was conducted, educating an additional 25 physicians and 23 pre-hospital personnel. Preliminary analysis of the data obtained is encouraging regarding significant improvement in the participants’ performance. There is also an increased awareness by the community and local leaders to develop a system that would address the needs of trauma patients, and to develop injury prevention programs as well as more continued medical education.

The philosophy of the Course and Trauma System were presented in the 90th American College of Surgeons, Ad-hoc Committee on Rural Trauma Annual Meeting held in San Francisco, CA on October 2005.

In April 2-4, 2008, the 3rd Basic Course on Trauma for physicians, the 2nd course on Pre-hospital care in Trauma and the 1st Course for nurses and pilots in charge of patients transportation all took place.

The preliminary assessment of these courses is encouraging, since an advancement in trauma care has been observed. There is an awareness in the community about the trauma problem and the need for its care, prevention and public education.

A Trauma Registry has also been developed and is currently being utilized to track and record data from injured patients in hopes that this will provide a true assessment of the trauma statistics in the province and will aid to determine the impact that education and awareness of trauma will have on improving patient care.


Image 2: Teaching trauma care to Pre-hospital personnel 

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