RT info:eu-repo/semantics/article T1 Challenges in care of trauma patient in Spain. The need for implementation of scientific evidence including secondary prevention T2 Retos asistenciales en la atención al paciente traumatizado en España. La necesidad de implementación de la evidencia científica incluyendo la prevención secundaria A1 Fernández Mondéjar, Enrique A1 Álvarez González, Francisco Javier A1 González Luque, Juan Carlos K1 Traumatismos K1 Uso de drogas AB The mortality of trauma patients has improved significantly in recent decades dueto a combination of factors: medical care, educational campaigns and structural changes. Generalizationof both out-of hospital emergence medical services and the hospital care in specificcenters for traumatized has undoubtedly contributed to this decline, but other factors such asperiodic campaigns to prevent workplace and traffic accidents, as well as improvements in theroad network have played a key role.The challenge now is to contain mortality, for which is essential an analysis of the situationto detect potential areas of improvement.The application of diagnostic or therapeutic actions with scientific evidence is associatedwith lower mortality, but as in other areas of medicine, the application of scientific evidencein trauma patients is barely 50%. Moreover, nearly 90% of trauma deaths occur in the crashsite or during the first 72 h of hospitalization, the vast majority as a result of injuries incompatiblewith life. In these circumstances it is clear that prevention is the most cost-effectiveactivity. As medical practitioners, our role in prevention is mainly focused on the secondaryprevention to avoid recidivism, for which it is necessary to identify the possible risk factors(frequently alcohol, illegal drugs, psychotropic medication, etc.) and implement a brief motivationalintervention. This activity can reduce recidivism by nearly 50%. In Spain, the activityin this field is negligible; therefore, measures should be implemented for dissemination ofsecondary prevention in trauma. PB Elsevier Doyma SN 0210-5691 YR 2014 FD 2014 LK http://uvadoc.uva.es/handle/10324/15250 UL http://uvadoc.uva.es/handle/10324/15250 LA eng NO Medicina Intensiva. 2014; 8(6):386-90 NO Producción Científica DS UVaDOC RD 13-jul-2024