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Journal Article

Citation

Lawton R, Atijosan R, Biring G. Inj. Extra 2009; 40(10): 210.

Copyright

(Copyright © 2009, Elsevier Publishing)

DOI

10.1016/j.injury.2009.06.238

PMID

unavailable

Abstract

Introduction: Hospital Services in Buckinghamshire have been reconfigured recently. Wycombe General Hospital now carries out only elective surgical procedures and Stoke Mandeville Hospital in Aylesbury now receives all trauma and surgical emergencies. Prior to the merger (up to 2004) Stoke Mandeville participated in the Trauma Audit and Research Network (TARN) but at the time of the merger funding was withdrawn. This project was to evaluate the current trauma workload, injury severity score and outcome of patients managed by the trauma team from August 2006 to August 2007. Methods: We used the switchboard log to find all occasions when the trauma team was mobilised. We then reviewed the A&E notes to determine mechanism of injury, injury severity score (ISS) and documented outcome. Results: There were 118 Trauma Calls during the 12-month period a mean of 2.3 calls per week. 69% took place outside normal working hours. The mechanism was a road accident (car occupant, pedestrian, cyclist or motorcyclist) in 68% of cases, a fall in 22% and 10% other (including violence). The mean ISS was 6, the mode 1 and the median 2. 2% died in A&E, 2% were transferred immediately to tertiary hospital, 4% directly to theatre, 4% admitted HDU, 58% admitted to ward, 24% formally discharged and 2% self-discharged from A&E. In 4% of cases the outcome was not documented.
Conclusions: Trauma calls at a district hospital are relatively uncommon occurring less than once a week during the normal working day and twice as frequently outside normal working hours. Fortunately most individuals do not have severe injuries. The range of injury severity scores is very wide and a few individuals each year have very severe injuries that require prompt and skilled resuscitation, evaluation and management.

Keywords: Trauma team; Injury severity score; Resuscitation; Mechanism

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