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European Respiratory SocietyTrauma Surgery2026advanced

Guidelines for Essential Trauma Care: Second Edition (2026).

Published by International Association for Trauma Surgery and Intensive Care (IATSIC) and the World Health Organization (WHO) · Core (Co) and Extended (Ex) priorities

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Summary

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Injury is a major cause of death and disability globally, with the highest burden in low- and middle-income countries (LMICs). In 2004, the International Association for Trauma Surgery and Intensive Care (IATSIC) and the World Health Organization (WHO) co-published the Guidelines for Essential Trauma Care (EsTC) to define achievable standards for trauma care resources anywhere in the world. The 2026 publication represents the first update and revision of these Guidelines.

globalinjurylow‐ and middle‐income countryresourcestrauma

Key Takeaways

  • 1
    Strengthening the organization and planning for trauma care can improve care and lower mortality globally.
  • 2
    The updated Guidelines contain detailed resource tables listing human resources (skills, training, staffing) and physical resources (equipment and supplies) that should be available at varying health care facilities (clinics, first-level, second-level, and tertiary hospitals).
  • 3
    Prioritizes resource availability into Core (Co) and Extended (Ex) designations to match varying resource settings.
  • 4
    Emphasizes that key administrative and organizational functions, such as quality improvement, triage, trauma registries, and trauma teams, are essential for ensuring quality trauma care.

Scope & Objectives

Clinical Topic

Essential Trauma Care

Objectives

To promote affordable and achievable standards for trauma care resources that could realistically be achievable at health care facilities anywhere in the world, even in the lowest-income settings, to strengthen trauma care services globally, especially in low- and middle-income countries.

Target Patient Population

Injured patients

Target Providers

Ministry of health plannersHospital administratorsTrauma care cliniciansSurgeonsEmergency physiciansAnesthetistsNurses

Patient Criteria & Setting

Therapeutic Area

Trauma and Emergency Care

Guideline Scope

Resource planningMinimum standardsFacility capabilities

Inclusion Criteria

  • Blunt trauma
  • Penetrating trauma
  • Burns

Exclusion Criteria

  • Prehospital care

Care Settings

ClinicsFirst-level hospitalsSecond-level hospitalsTertiary hospitals

Special Populations

Children

Evidence Grading

System: Core (Co) and Extended (Ex) priorities

Safety & Contraindications

Contraindications

  • Downgrading core items in national plans should be rare.
  • Cooling of burn wounds should be avoided when the risk of hypothermia outweighs the benefits of cooling.
  • Do not close wounds when they are too severely contaminated.

Monitoring Guidance

Core monitoring includes clinical assessment of airway compromise, respiratory distress, and shock (vital signs, capillary refill, skin temperature). Table-specified monitoring resources include stethoscope, BP cuff, thermometer, urinary catheter with collection bag, pulse oximetry, and electronic cardiac monitoring.

Authors & Contributors

Valencia AdjeiRoger AlcockVanda AmadoMichael BoampongSanjeev BooiPetra BrysiewiczCorazon Cabanilla-ManuntagCristiane de Alencar DominguesGhada ElhadariRanjith Nanda EllawalaSarnai ErdeneAmaAkoma EssumanJorge Esteban FoianiniFilippo GattiArmando Garcia GuererraGreg HynesAdil HaiderSandy InglessBalavenkata JagannathanHelen JowettKnut Magne KolstadbråtenSonja KrofakAireen Patricia MadridTina TomićMahečićClaude MartinDaniel NtogwrachuBisola Onajin-ObembeNhobojit RoyAndres RubianoNiisoja Mensah TortoBen WachiraMeg WalmsleyTorben WisborgElma Wong

Guideline Features

Dosing informationBased on systematic reviewMultidisciplinary

Learning Context

Difficulty

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