Adult major trauma in France: A roadmap for comprehensive and coordinated care.
Anaesthesia, critical care & pain medicine · 2026-05-30 · Guideline / consensus
Abstract
BACKGROUND: Despite a substantial burden, trauma care in France remains insufficiently structured at the national level. While France has pioneered physician-led prehospital emergency systems, trauma care organizations vary across regions and lack meaningful national coordination. This position paper, developed by experts from the Groupe d'Interface en Traumatologie Grave (GITE), describes the current organization of trauma care in France, identifies structural gaps across the continuum of care, and proposes strategic priorities to strengthen a coordinated national trauma system. PRIORITY PERSPECTIVES: Optimal outcomes depend on accurate recognition of major trauma patients and timely orientation to the most appropriate care pathway within regional systems. Despite a high level of clinical expertise, significant limitations persist, including fragmented trauma networks without national coordination, absence of standardized trauma centre accreditation, heterogeneous triage implementation, and insufficient integration between prehospital services, hospitals, and rehabilitation pathways. National data systems also remain incomplete, limiting the ability to monitor performance and support quality improvement. To address these challenges, this article proposes targeted actions and introduces key performance indicators spanning the trauma pathway. These indicators aim to provide a standardized framework for evaluating trauma care delivery and to support benchmarking, research, and continuous system improvement. CONCLUSIONS: France benefits from strong clinical expertise and substantial technical resources for major trauma care. However, greater coordination across the trauma care pathway is needed to fully leverage these assets. A structured national trauma strategy, with standardized governance, integrated registries, and defined performance indicators, could improve system performance, reduce regional disparities, and strengthen resilience.