Filières de soins en traumatologie, une organisation indispensable

From prehospital management through tertiary hospital care and rehabilitation, many facilities and medical specialities have an influence on injured patient's mortality. Anglo-saxon countries implemented regional trauma network “Trauma system” which organized prehospital trauma triage to tertiary trauma centres. In France, injured patients are transported to the closest and most appropriate facility according to the on-scene triage done by an emergency physician. Faced with the development of new techniques in trauma care, many facilities cannot provide definitive care and inappropriate patient triage will increase prehospital transfer time. A regional trauma network is essential to organize the initial prehospital triage and shared the medical resources. Since 2008, the Northern French Alps Emergency Network created with the Alps trauma centre of Grenoble University Hospital, a trauma system with emergency physicians, anaesthesiologists, radiologists and surgeons from three departments which combined the particularities of the French emergency medical service and regional network. The quality management of this unique experience in France is evaluated by a trauma registry. Network and audit are essential to improve the quality of care. Bystander witnesses, medical call dispatch center, emergency physicians, anaesthesiologists, radiologists and surgeons set up a survival chain.