中国在过去的30年里随着经济的巨大进步，工业化水平的逐年提升导致了意外伤害事故也随之增加，中国每年因创伤死亡人数超过400 000，是继恶性肿瘤和心、脑、呼吸道疾病后的第五大死亡原因，是青壮年死亡的首要原因［1］，同时创伤已成为和平时期一项严重的社会问题。目前，中国对于创伤急救体系的建设仍然处于起始阶段，投入还相当不足，也没有特定的政府机构来协同处理创伤急救相关问题，如决策的制定、急救基金的设立、急救的立法、创伤急救系统的建立、创伤医师的再教育和认证等［2］。
欧美等发达国家的创伤急救系统建设起步于20世纪60年代，发展到今天已经相对比较完善［2］，而我国创伤急救系统的建设才刚刚起步，近年来姜保国教授团队也在大量研究的基础上提出了适合中国国情的创伤救治模式，但尚未形成规模，还处于试行与推广阶段。创伤救治体系从评价医疗服务质量角度分析，目前世界上主要有两大急救体系：即美英模式和德法模式。前者的特点是“将患者带往医院”，强调在现场紧急处理后尽快把伤员安全转运至医院再行有效治疗；后者则是“将医院送至患者身边”，强调医院抢救小组尽快到达现场进行救治，再转运患者至医院继续治疗［3］。目前采用美英模式的国家和地区有澳大利亚、加拿大、以色列、日本、新西兰、菲律宾、中国台湾、中国香港、美国、英国；采用德法模式的国家和地区有奥地利、比利时、拉脱维亚、挪威、波兰、葡萄牙、俄罗斯、瑞典、瑞士、德国、法国。中国目前的创伤救治模式总体上介于两者之间，下面对两种模式的代表国家德国和美国进行分类介绍，并阐述我国当前救治现状中的优缺点。

With the great progress of the economy, the level of industrialization has been increasing year by year, which leads to an increase in accidental trauma accidents. Chinese annual death of trauma is already more than 400 000, which makes trauma the fifth most common cause of death, following malignant tumor, heart, brain and respiratory diseases. Trauma is the leading cause of the death of young adults. At the same time, trauma has become a serious social problem in peacetime. Trauma throws great treats on human health and life. As an important part in the medical and social security system, the emergency of trauma system occupies a very important position in the emergency medical service system. In European countries as well as the United States and also many other developed countries, trauma service system had a long history, and progressed to an advanced stage. However, Chinese trauma service system started late and is still developing. It has not turned into a complete and standardized system yet. This review summarizes the histories and current situations of the development of traumatic first aid system separatedly in European countries, the United States and our country. Special attentions are paid on the effects of the pre- and in-hospital emergency care. We also furtherly try to explore the Chinese trauma emergency model that adapts to the situations of China and characteristics of different regions of China. Our rievew also introduces the trauma service system that suits the situations of China proposed by Prof. Jiang Baoguo’s team in details, and taking Chinese conditions into account, they conducted a thematic study and made an expert consensus on pre-hospital emergency treatment of severe trauma, providing a basic rountine and guididance of severe trauma treatment for those pre-hospital emergency physicians. They also advised the establishment of independent trauma disciplines and trauma specialist training systems, and to build the regional trauma care system as well as the standards for graded treatment, thus establishing a multiple disciplinary team (MDT) of severe trauma. In this way, we can reduce the mortality and disability risks of severe trauma, improve the quality of patients’ life, and save more lives.