Can residents be effective trauma team leaders in a major trauma centre?

Injury ◽  
2013 ◽  
Vol 44 (1) ◽  
pp. 18-22 ◽  
Author(s):  
E.M. Cole ◽  
A. West ◽  
R. Davenport ◽  
S. Naganathar ◽  
T. Kanzara ◽  
...  
Keyword(s):  
Major Trauma ◽  
Trauma Team ◽  
Trauma Centre ◽  
Team Leaders ◽  
Major Trauma Centre

scholarly journals A profile of a major trauma centre of North West England between 2011 and 2018

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Raimundas Lunevicius ◽  
Mina Mesri
Keyword(s):  
Traffic Accidents ◽  
Major Trauma ◽  
Road Traffic ◽  
Survival Rates ◽  
Trauma Team ◽  
Trauma Centre ◽  
North West ◽  
Major Trauma Centre ◽  
Mortality Ratio ◽  
Expected Mortality

AbstractThis study examined the trends and patterns of major trauma (MT) activities, causes, mortality and survival at the Aintree Major Trauma Centre (MTC), Liverpool, between 2011 and 2018. The number of trauma team activations (TTAs) rose sharply over time (n = 699 in 2013; n = 1522 in 2018). The proportion of TTAs that involved MT patients decreased from 75.1% in 2013 to 67.4% in 2018. The leading cause of MT was a fall from less than 2 m (36%). There has been a fivefold increase in the overall number of trauma procedures between 2011 and 2018. Orthopaedic surgeons have performed 80% of operations (n = 7732), followed by neurosurgeons, oral and maxillofacial surgeons, and general trauma surgeons. Both types of fall (> 2 m and < 2 m) and road traffic accidents were the three leading causes of death during the study period. The observed mortality rates exceeded that of expected rates in years 2012, 2014, 2016 and 2017. The all-cause observed to expected mortality ratio was 1.08 between 2012 and 2018. A change in care for MT patients was not directly associated with improved survival, although the marginally ascending trend line in survival rates between 2012 and 2018 reflects a gradual positive change.

Undertriage of the elderly major trauma patient continues in major trauma centre care: a retrospective cohort review

2020 ◽  
pp. emermed-2019-208541
Author(s):  
Antonia C Hoyle ◽  
Leela C Biant ◽  
Mike Young
Keyword(s):  
Older Patients ◽  
Major Trauma ◽  
Trauma Team ◽  
Trauma Centre ◽  
Trauma Patients ◽  
Severely Injured ◽  
Severely Injured Patients ◽  
Major Trauma Centre ◽  
Trauma Triage ◽  
Injured Patients

BackgroundMajor trauma (Injury Severity Score (ISS) ≥16) in older people is increasing, but concerns persist that major trauma is not always recognised in older patients on triage. This study compared undertriage of older and younger adult major trauma patients in the major trauma centre (MTC) setting to investigate this concern.MethodsA retrospective review of Trauma Audit and Research Network data was conducted for three MTCs in the UK for 3 months in 2014. Age, ISS, injury mechanism and injured areas were examined for all severely injured patients (ISS ≥16) and appropriate major trauma triage rates measured via the surrogate markers of trauma team activation and the presence of a consultant first attender, as per standards for major trauma care set by National Confidential Enquiry into Patient Outcomes and Deaths, Royal College of Surgeons of England and the British Orthopaedic Association. Trends in older (age ≥65) and younger (ages 18–64) adult major trauma presentation, triage and reception were reviewed.ResultsOf 153 severely injured patients, 46 were aged ≥65. Older patients were significantly less likely to receive the attention of a consultant first attender or trauma team. Similar trends were also seen on subgroup analysis by mechanism of injury or number of injured body areas. Older major trauma patients exhibit a higher mortality, despite a lower median ISS (older patient ISS=20 (IQR 16–25), younger patient ISS=25 (IQR 18–29)).ConclusionOlder major trauma patients are at greater risk of undertriage, even in the MTC environment. Existing hospital trauma triage practices should be further investigated to explain and reduce undertriage of elderly trauma patients.

Using full immersive simulation to prepare trauma teams to work in a major trauma centre

Trauma ◽  
2016 ◽  
Vol 19 (4) ◽  
pp. 277-285
Author(s):  
Simon J Mercer
Keyword(s):  
Major Trauma ◽  
Damage Control ◽  
Trauma Team ◽  
Trauma Centre ◽  
Clinical Environment ◽  
Major Trauma Centre ◽  
Management Concepts ◽  
Trauma Teams ◽  
The Uk ◽  
Simulation Centre

A reconfiguration of trauma services in the UK has led to the development of trauma networks with major trauma centres. This article describes the use of fully immersive simulation to train whole trauma teams in both a traditional simulation centre setting and ‘in situ’ in the clinical environment. Carefully designed scenarios that are driven by experienced faculty allow modern trauma management concepts, such as damage control resuscitation and massive transfusion to be explored within a hospital’s own organisational structure. Human factors specific to the trauma team can also be explored as part of a video-assisted debrief.

scholarly journals A cross-sectional study of knife injuries at a London major trauma centre

2014 ◽  
Vol 96 (1) ◽  
pp. 23-26 ◽  
Author(s):  
JR Pallett ◽  
E Sutherland ◽  
E Glucksman ◽  
M Tunnicliff ◽  
JW Keep
Keyword(s):  
Major Trauma ◽  
Case Fatality ◽  
Trauma Team ◽  
Cross Sectional Study ◽  
Trauma Centre ◽  
Mortality Data ◽  
Contributory Factor ◽  
Cross Sectional ◽  
Major Trauma Centre ◽  
Knife Injury

INTRODUCTION No national recording systems for knife injuries exist in the UK. Understanding the true size and nature of the problem of knife injuries is the first stage in reducing the burden of this injury. The aim of this study was to survey every knife injury seen in a single inner city emergency department (ED) over a one-year period. METHODS A cross-sectional observational study was performed of all patients attending with a knife injury to the ED of a London major trauma centre in 2011. Demographic characteristics, patterns of injury, morbidity and mortality data were collected. RESULTS A total of 938 knife injuries were identified from 127,191 attendances (0.77% of all visits) with a case fatality rate of 0.53%. A quarter (24%) of the major trauma team’s caseload was for knife injuries. Overall, 44% of injuries were selfreported as assaults, 49% as accidents and 8% as deliberate self-harm. The highest age specific incident rate occurred in the 16–24 year age category (263/100,000). Multiple injuries were seen in 19% of cases, of which only 81% were recorded as assaults. The mean length of stay for those admitted to hospital was 3.04 days. Intrathoracic injury was seen in 26% of cases of chest trauma and 24% of abdominal injuries had a second additional chest injury. CONCLUSIONS Violent intentional injuries are a significant contributory factor to the workload of the major trauma team at this centre. This paper contributes to a more comprehensive understanding of the nature of these injuries seen in the ED.

scholarly journals Falls downstairs: The impact on a UK major trauma centre

Trauma ◽  
2021 ◽  
pp. 146040862110029
Author(s):  
Joshua Callon ◽  
Daniel Thomas ◽  
Simon J Mercer
Keyword(s):  
Older Patients ◽  
Major Trauma ◽  
Average Length ◽  
Trauma Team ◽  
Trauma Centre ◽  
Trauma Patients ◽  
Mechanism Of Injury ◽  
Younger Patients ◽  
Major Trauma Centre ◽  
The Impact

Introduction Major trauma centres are increasingly managing a significant injury burden in older patients, with falling downstairs being a prevalent mechanism of injury. Literature evaluating the impact of falls on stairs upon UK trauma networks is limited. Gaining a greater understanding of this may allow for more effective planning of services and improvements in training and education. This study evaluates the impact of falls downstairs on a UK major trauma centre. Methods A single centre retrospective service evaluation of local major trauma data over a 3-year period from 01/01/2017 to 31/12/2019. Included were patients who activated a trauma call whose mechanism of injury recorded at the time of admission was a fall downstairs. We excluded patients less than 16 years of age. Results There were 4480 major trauma patients who presented in the study period and of these, 860 (19.2%) sustained injuries following a fall downstairs. The most common age group presenting was 70–79 years; younger patients (<60 years) made up 43.3% with the majority (56.7%) being older. All but one patient were managed by a consultant-led trauma team, 6.4% of patients were admitted to critical care and 1% received an urgent operation. The overall mortality rate was 8.5%. Older patients made up 85% of those who died and had nearly four times longer average length of stay than younger patients (9.69 v 2.49 days). Conclusion Falls downstairs place a significant burden on the major trauma centre. There is a stark contrast in the use of hospital resources and outcomes between older and younger patients.

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