Trauma patients require specialized care including surgery and often blood transfusion within the so-called Golden Hour of emergency medicine, or sixty minutes. This time frame is not a strict requirement, but it serves to point out the critical first hours after the injury in which most deaths from trauma occur. To help ensure that injured people reach appropriate care in a timely manner, many areas have organized trauma referral systems. Research has shown that deaths from physical trauma decline in areas where organized trauma systems are implemented.
In the field, emergency medical technicians, paramedics, and sometimes specialized nurses, known as 'first responders', use stabilization techniques to improve the chances of a trauma patient surviving the ambulance trip to the hospital. Professionals begin performing a primary survey, consisting of assessment of airway, breathing, and circulation (called the "ABC's"). The purpose of the primary survey is to identify life-threatening problems. Ensuring that the injured person is not disabled by unnecessary movement of the spine is paramount, so the neck and back are secured before moving the patient. Unless the victim is in imminent danger of death, first responders will usually perform a load and go, transporting the victim immediately to the nearest appropriate trauma-equipped hospital.
Upon completion of the primary survey, the secondary survey is begun. This may occur during transport or upon arrival at the hospital. The secondary survey consists of a systematic assessment of the abdominal, pelvic and thoracic viscera, complete inspection of the body surface to find all injuries, and neurological exam. The purpose of the secondary survey is to identify all injuries so that they may be treated. A missed injury is one which is not found during the initial assessment (for example, as a patient is brought into a hospital's Emergency Department), but rather manifests itself at a later point in time, sometimes with baleful consequences (i.e., a liver laceration is sometimes missed and a patient sent home, who will abruptly go into shock shortly thereafter.)
The appropriate first aid for a trauma patient is to immediately call for help using the emergency medical service, then treat for shock. Do not move the victim unless failure to do so would create a greater risk to their life (i.e. hazardous chemicals or a spreading fire). Also see wilderness first aid if immediate emergency help is unavailable.