Recursos Humanos,físicos y Procesos para la Atención del Trauma durante el Período Dorado

The World Health Organization (WHO) and the American College of Surgeons (ACS) have issued recommendations regarding the physical and human resources needed for the care of the injured patient. The implementation of one of these recommendations (WHO) in Ecuador in 2007, showed significant weaknesses, but at the same time opportunities for change. Years have passed and trauma care has improved. The objective of this study was to develop and evaluate a digital tool used in the evaluation of physical resources, human resources, guidelines and processes for trauma care in southern Ecuador during the first hours after the event, a period known as the "golden period", as well as to review the current status of these in order to have a situational diagnosis that allows us to compare them with the recommendations of the World Health Organization. Methods: Observational, descriptive study. We listed 560 variables based on the standards of the World Health Organization, both hospital and pre-hospital, in addition to the recommendations of the National Academy of Medicine of Argentina. A digital tool was built to include these variables. This tool was used in the pre-hospital and hospital evaluation, initially as a pilot project in a nearby second level hospital and later in the main medical centers in the southern area of Ecuador. A database was constructed and analyzed in STATA. Results. We present SINATRA, a PC-based software built with 560 variables for prehospital and hospital evaluation in trauma. Seven hospitals were evaluated, including the pilot, as well as those responsible for the prehospital system. Conclusions. Although both the proposed evaluation model and the developed tool present difficulties for its management, mainly due to its extension, it is undoubtedly a good initial basis for further work and improvement. With future improvements, it could become a useful digital tool for the evaluation of trauma care not only locally, but also nationally or regionally, and could eventually be sponsored and disseminated by the Pan American Trauma Society.