In December 2023, the Trauma Professional Committee of the American Society of Surgeons officially released the seventh edition of "Resources for Optimal Care of the Injured Patient (2022 Stan-dards)". Compared to the sixth edition of the standards, the main updated content of the seventh edition includes ten aspects: (1) trauma centers need to meet new personnel configuration and qualification requirements, (2) trauma centers need to develop more structured and effective trauma treatment effectiveness improvement and patient safety plans, (3) trauma centers need to develop data quality plans, (4) trauma centers need to develop new diagnosis and treatment plans for specific patients, (5) trauma centers need to have new professional knowledge, (6) trauma centers need to meet new response time and resource availability standards, (7) trauma centers need to meet new academic and scientific requirements, (8) tertiary trauma centers need corresponding qualification certificates if providing neurological trauma treatment, (9) new requirements for pediatric trauma centers, (10) the fourth level trauma center standards. The research literature published by scholars in the field of trauma in the past decade has provided sufficient evidence-based medicine evidence for updating content. The article introduces and analyzes the updates in the seventh edition standards in light of the available evidence.
Humans ; Trauma Centers/standards* ; Wounds and Injuries/therapy* ; Societies, Medical ; Surgeons/standards* ; United States

OBJECTIVEInjuries are common and important problem in Tehran, capital of Iran. Although therapeutic centers are not essentially established following the constructional principles of developed countries, the present opportunities and equipments have to be used properly. We should recognize and reduce the deficits based on the global standards. This study deliberates the trauma resources and capacities in university hospitals of Tehran based on Arizona trauma center standards, which are suitable for the assessment of trauma centers.

METHODSForty-one university hospitals in Tehran were evaluated for their conformity with "Arizona trauma center standards" in 2008. A structured interview was arranged with the "Educational Supervisor" of all hospitals regarding their institutional organization, departments, clinical capabilities, clinical qualifications, facilities and resources, rehabilitation services, performance improvement, continuing education, prevention, research and additional requirements for pediatric trauma patients. Relative frequencies and percentages were calculated and Student's t test was used to compare the mean values.

RESULTSForty-one hospitals had the average of 77.7 (50.7%) standards from 153 Arizona trauma center standards and these standards were present in 97.5 out of 153 (63.7%) in 17 general hospitals. Based on the subgroups of the standards, 64.8% items of hospital resources and capabilities were considered as a subgroup with the maximum criteria, and 17.7% items of research section as another subgroup with the minimum standards.

CONCLUSIONSOn the basis of our findings, no hospital meet all the Arizona trauma center standards completely. The hospitals as trauma centers at different levels must be promoted to manage trauma patients desirably.

Arizona ; Hospitals, University ; standards ; Humans ; Iran ; Trauma Centers ; standards

INTRODUCTIONSome studies have demonstrated an increased risk of death for patients admitted at nights or during weekends. This study was undertaken to investigate the demographic profile, medical interventions and outcome of severe head injury patients stratified according to day and time of admission to a specialised neurosciences intensive care unit (NICU).

MATERIALS AND METHODSA retrospective study using a prospectively maintained severe head injury database in a tertiary hospital. Admissions to the NICU were grouped into weekdays, weeknights and weekends. A comparison of patients admitted during the day and night hours were also made.

RESULTSA total of 838 severe head injury patients admitted to NICU were included in the study, of which 263 were admitted on weekdays, 327 on weeknights and 248 on weekends. More patients were admitted during the night (496) compared to during the day (342). There were no significant differences in the demographic profile, mechanism of injury, severity of injury, need for neurosurgical intervention, and duration of mechanical ventilation, intensive care unit (ICU) stay and mortality associated with day and time of admission. In multivariate analyses controlling for confounding factors, no statistically significant difference in ICU mortality was found with the day and time of admission.

CONCLUSIONSThere were more severe head injury patients admitted to ICU at night and on weekends, with no significant difference in demographic profile, types of injuries, need for neurosurgical interventions and duration of ICU stay and mortality in a specialised NICU with adequate staffing and requisite diagnostic and therapeutic modalities available.

Adult ; Aged ; Craniocerebral Trauma ; mortality ; Female ; Glasgow Coma Scale ; Hospital Mortality ; Hospitalization ; Humans ; Intensive Care Units ; Male ; Middle Aged ; Outcome Assessment (Health Care) ; Retrospective Studies ; Singapore ; epidemiology ; Time Factors ; Trauma Centers ; standards