Rural and austere environments

Abstract

Great strides have been made in the management of traumatic injury in the United States over the last 50 years. The establishment of regional trauma centers and expanding technological advances has significantly reduced morbidity and mortality. There remains, however, a population of trauma victims who are geographically isolated from these major centers and the care of these individuals is borne by the practitioners in these rural and remote communities. This chapter discusses the challenges faced by both these rural providers as well as the tertiary consultants as they attempt to provide state of the art treatment under austere conditions. Strategies to assist in assuring the competency of the staffs in rural facilities are discussed along with the use of telemedicine and various other modalities in the management of the polytraumatized patient.