Trauma
Care Continuum

TCC

Trauma Care Continuum (TCC)

Structure

Overall prevention...

The TSC carries out prevention according to Haddon's matrix:

  •  PRIMARY, in the PREACCIDENT phase, through accident prevention;
  •  SECONDARY, when a COLLISION occurs, through injury prevention;
  •  TERTIARY, in the POST-COLLISION phase, through reduction of mortality and morbidity associated with injuries sustained in an accident.

Types of services

The TSC, in its POST-COLLISION phase, covers three types of services:

PREHOSPITAL services include all of the service providers in the system, from the moment a 911 call is made to report an accident:

  • 911 dispatchers and dispatch centres;  
  • Police and first responders. Through early standardized response procedures, they stabilize and secure an accident scene and accident victims until the arrival of an ambulance;
  • Ambulance attendants. They transport accident victims to designated care facilities that treat accident victims.

Physical health HOSPITAL services are provided by designated health agencies that ensure delivery of services based on available resources. Trauma care and services centres are classified as follows:

  • Stabilization services, if the facility is located in a remote or isolated area and if it provides stabilization care, primarily in the field of respiratory care. The victim has to stay at the facility to be stabilized for a maximum of 10 minutes.
  • Primary, if they are located more than 30 minutes away from a secondary or tertiary trauma care and services centre and if they provide general surgery and anesthesia;
  • Secondary, if they provide general surgery, orthopedic care, multidisciplinary critical care and early rehabilitation;
  • Regional secondary, if they provide supplementary orthopedic care. Some regional secondary trauma care and services centres, which are part of a consortium of care and social facilities, are responsible for providing highly specialized neurotrauma services in their region;
  • Tertiary, if they provide specialized and highly specialized trauma care, neurosurgery, specialized intensive care and early interdisciplinary rehabilitation. Some tertiary trauma care and services centres, which are part of a consortium of care and social facilities, are responsible for providing highly specialized neurotrauma services in their region. Some tertiary trauma care and services facilities are part of an expert care centre that provides services to victims of spinal cord injuries and severe burn victims.
  • Facilities that provide expert care for victims of spinal cord injuries, severe burns or individuals who require emergency reimplantation microsurgery. These facilities carry out their work as part of a consortium known as an expert care centre.

POSTHOSPITAL services are made available to accident victims whose lifestyles are permanently threatened by one or more impairments as a result of injury sustained in an accident. Rehabilitation services are provided on an inpatient or outpatient basis, depending on the needs of clientele. Community maintenance services are also provided to trauma victims with permanent disabilities to enable them and individuals close to them, to achieve an optimal quality of life and level of social participation.

Pre-collision Collision Post-collision

Prehospital

Hospital

Readaptation