title: Ratification of IATSIC/WHO's guidelines for essential trauma care assessment in the South American region.
abstract: BACKGROUND
  The purpose of the present study was to evaluate the usefulness of the International Association for Trauma Surgery and Intensive Care (IATSIC)/World Health Organization (WHO)'s Guidelines for Essential Trauma Care (EsTC Guidelines) in providing an internationally applicable and standardized template to assess trauma care capabilities in the South American Region.
  
  
  METHODS
  Field assessment was conducted in seven provinces (urban and rural, pop. 2,239,509) and 24 facilities (5 large hospitals (LH); 15 small hospitals (SH); 4 basic hospitals (BH)) in Ecuador using EsTC criteria. A total of 260 individual items in Human Resources (HR- availability, clinical knowledge, skills) and physical resources (PR) were evaluated via inspection, review of local statistics, and administrative and staff interviews. EsTC was evaluated on a scale as follows: 0 (absent); 1(inadequate; < 50%); 2 (partly adequate > 50%); 3 (adequate-100%).
  
  
  RESULTS
  210,045 Emergency Department (ED) visits and 61,365 (29%) ED trauma visits were recorded (incidence rate 2,740/100,000 population). Deficits were noted in prehospital trauma care (inadequate coordination, communication), education and training (ATLS < 30%, TNCC 0%), facility based trauma care (poor physical resources [PR] and human resources [HR]), and quality assurance (1/27 hospitals).
  
  
  CONCLUSIONS
  The IATSIC/WHO EsTC Guidelines provide a simple and useful template to assess trauma care capability in variable facilities and international settings, and they could serve as a valuable tool for trauma system development. Endorsement of EsTC Guidelines by the Panamerican Health Organization and lead trauma societies (the Panamerican Trauma Society) should be considered.
authors.affiliation: Department of Surgery, International Trauma System Development Program, Virginia Commonwealth Medical Center, 1200 East Broad Street, Richmond, VA 23298, USA. mbaboutanos@vcu.edu
authors.forename: Michel B
authors.initials: MB
authors.lastname: Aboutanos
authors.forename: Francisco
authors.initials: F
authors.lastname: Mora
authors.forename: Edgar
authors.initials: E
authors.lastname: Rodas
authors.forename: Juan
authors.initials: J
authors.lastname: Salamea
authors.forename: Marcelo Ochoa
authors.initials: MO
authors.lastname: Parra
authors.forename: Estuardo
authors.initials: E
authors.lastname: Salgado
authors.forename: Charlie
authors.initials: C
authors.lastname: Mock
authors.forename: Rao
authors.initials: R
authors.lastname: Ivatury
mesh_terms: D004484:Ecuador / Q000453:epidemiology; D017408:Guidelines as Topic; D006287:Health Planning Guidelines; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D014944:World Health Organization; D014947:Wounds and Injuries / Q000453:epidemiology* / Q000628:therapy*