The Royal College of Surgeons (RCS) has announced the publication of a detailed plan to assist Strategic Health Authorities in developing regional trauma systems across the country. The guidance maps out what is required in terms of equipment, staff, space and experience for centres designated as major trauma centres and trauma units (which will look after patients with less severe injuries), tracking the patient from the first pre-hospital clinical contact following injury right through to rehabilitation.
Severe injury from accidents is the leading cause of death among children and young adults of 44 years and under in the UK and trauma is one of the few disease categories where mortality is rising. Despite improvements in trauma care techniques, the likelihood of dying from serious injuries has remained static for 15 years in the UK. In the US, where regional trauma systems have been established for many years, the number of severely injured people who arrive at hospital alive and survive is 40% higher than in the UK.
It is estimated that thousands of lives could be saved and severe disabilities prevented by providing regional major trauma centres supported by a network of trauma units. The report highlights evidence that the introduction of high-volume major trauma centres would reduce deaths among the most seriously injured by up to 50%.
In order for the full potential of trauma centres to be realised, the guidance says that rapid assessment of patients at the scene is required – with the most seriously injured identified and transported directly to a major trauma centre, even if that is not the nearest hospital. Major trauma patients represent less than one in every thousand emergency hospital admissions and there is evidence that, for these patients, length of journey is less important than getting the best care when the patient arrives. The report, Regional Trauma Systems: Guidance for Commissioners, also demonstrates that in order to get the best results, major trauma centres need to treat more than 400 severely injured patients a year – most hospitals could currently expect to see only a fraction of this number.
