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Figure 2-1 The Edwin Smith Papyrus, ca. 1600 B.C., is the oldest known text describing treatments of injuries.

Figure 2-1 The Edwin Smith Papyrus, ca. 1600 B.C., is the oldest known text describing treatments of injuries.

the French army who in 1797 designed the ambulance volante. These flying ambulances were horse drawn wagons that carried the wounded from the battlefield to a base hospital, the first mobile army surgical hospital (MASH), a self-contained United States Army military unit. This improved treatment and survival, being able to treat the wounded immediately rather than waiting for the end of the battle. He also developed the concept of triage during this time. "The best plan that can be adopted in such emergencies, to prevent the evil consequences of leaving soldiers who are severely wounded without assistance, is to place the ambulance as near as possible to the line of the battle, and to establish headquarters to which the wounded, who require delicate operations, shall be collected to be operated on by the surgeon general. Those who are dangerously wounded should receive the first attention, without regard to rank or distinction. Those who are injured to a less degree may wait until their brethren-in-arms, who are badly mutilated, have been operated and dressed, otherwise the latter would not survive many hours, rarely until the succeeding day."1

With these foundations, trauma care evolved over the next two centuries into an intricate system of care that is universally adopted. As medical knowledge improved and research revealed the hidden truths of human physiology, so did trauma care. Collectively, the knowledge became advanced trauma life support.

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