An update on developing a NI Major Trauma Network. Dr Duncan - - PowerPoint PPT Presentation

▶
an update on developing a ni
SMART_READER_LITE
LIVE PREVIEW

An update on developing a NI Major Trauma Network. Dr Duncan - - PowerPoint PPT Presentation

Jan 31, 2024 128 likes •451 views

An update on developing a NI Major Trauma Network. Dr Duncan Redmill, Lead Clinician NIMTN Consultant in Emergency Medicine RVH An Estimation of our True Major Trauma Workload The societal cost of accidental injury in Northern Ireland is

slide-1
SLIDE 1

An update on developing a NI Major Trauma Network.

Dr Duncan Redmill, Lead Clinician NIMTN Consultant in Emergency Medicine RVH

slide-2
SLIDE 2
slide-3
SLIDE 3

An Estimation of our True Major Trauma Workload

  • The societal cost of accidental injury in

Northern Ireland is estimated to exceed £4.3 billion annually

  • Recent TARN data NI incidence suggests

approximately 3000 cases pa

  • This includes 1000 cases > ISS 15 pa.
slide-4
SLIDE 4

NI Major Trauma Network 2017

Network Board HSC Trusts Ambulance Service HSCB / PHA / DH

Clinical Advisory Group Service Users Nursing & Allied Health Professionals

slide-5
SLIDE 5
slide-6
SLIDE 6
slide-7
SLIDE 7

Trauma is time sensitive

slide-8
SLIDE 8
slide-9
SLIDE 9

Systems not Structures

‘the workforce is still fragmented in silos and divided by administrative and professional boundaries’

Bengoa Report (2016)

slide-10
SLIDE 10
slide-11
SLIDE 11
  • Major Trauma Triage tool
  • Major haemorrhage in trauma policy
  • Traumatic cardiac arrest
  • Emergency resuscitative thoracotomy
  • Silver Trauma recommendations
  • Paediatric radiology guidance
  • Regional patient care pathway
  • Support to HEMs in developing policy
  • Whole body CT in adults for major trauma
  • Regional guidance for the management of multiple

rib fractures

  • Regional approach to trauma team / TILS

Clinical Advances to date.

slide-12
SLIDE 12

Working together.

  • Regional training programme
  • TILS training
  • Trauma ward training
  • Visiting trust trauma committee
  • SAI commentary
  • Engagement with local brain injury charity
  • Regional mass casualty planning
  • Damage control surgery conference
slide-13
SLIDE 13

TARN reports.

slide-14
SLIDE 14
slide-15
SLIDE 15

Specific guidance in the elderly.

slide-16
SLIDE 16

(i) Heightened awareness of this population with low severity of mechanism of injury, late identification and prolonged investigation / treatment phase. (ii) Education both pre-hospital with consideration of an appendix for the elderly within the trauma triage tool. Launch an in hospital campaign to include promotion of older persons trauma courses, local presentations and resus posters. (iii) Use of a Silver trauma safety protocol – see resus poster in appendix. (iii) Consideration of unique arrangements required within the NI Major Trauma Network to facilitate timely access to trauma care; in particular early senior review, investigation and transfer to MTC despite late identification if appropriate. (iv) Reconsider Trauma team activation criteria in the older person.

Actions as per NIMTN Board / CAG

slide-17
SLIDE 17
slide-18
SLIDE 18
slide-19
SLIDE 19
slide-20
SLIDE 20
slide-21
SLIDE 21
slide-22
SLIDE 22

Cross border collaboration

A Trauma System for Ireland Report of the Trauma Steering Group

“The Department of Health and HSE should continue to explore the potential for all-island collaboration to improve access to trauma services, particularly in border areas”

slide-23
SLIDE 23

Damage Control Surgery

  • DCS conference NI 2018 – Mr Adam Brooks

Nottingham.

  • DSTS course RCS Eng, x22 places booked for MTC

surgeons Feb / April / June 19 .

  • Applying to set up NI DSTS course, to be run from

QUB cadaveric facility.

slide-24
SLIDE 24

Developing the Major Trauma Service at the MTC

  • Large business case for RVH site approved by HSC early 2019
  • Development of an 8 bedded Major Trauma Ward
  • Led by MDT trauma consultant of the week, Trauma project manager

and patient co-ordinator.

  • Timely input of all relevant specialties
  • AHP support, nursing, HCA, Physio / OT, rehabilitation, psychology
  • Development of TIG trauma fellowship at RVH
  • Developing a business case for Paediatric MTC status
  • Increased pool of TARN data co-ordinators
  • Visit East Midlands MTC April 19
  • Running a virtual trauma service currently
  • Cohorted patients do better
slide-25
SLIDE 25
slide-26
SLIDE 26

Timescales

  • HEMs landing site RVH – March 2019
  • Call and send proposal April 2019
  • Trauma bypass and repatriation August 2019
slide-27
SLIDE 27

Call and send proposal.

slide-28
SLIDE 28

Referral / Reverse referral policy.

slide-29
SLIDE 29

Repatriation

slide-30
SLIDE 30
slide-31
SLIDE 31

Potential Advances in next 12 months

  • Call and Send launched / phased ?
  • Trauma ward opens
  • Trauma network / bypass launched
  • HEMS service expands – blood products / trauma retrieval / HEMS landing at

RVH

  • Elderly trauma care development
  • Trauma coagulopathy pathway
  • Rehabilitation roles expanded including AHP / psychology support
  • TARN data collectors expansion
  • Regional trauma training including TWILS
  • DSTS local course
  • Ortho plastics service at RVH expands
  • Trauma research
slide-32
SLIDE 32

I want an operation. In the best place. By experts, who talk to each other and who talk to me. When I’m ready. After I’ve been fixed, it’s up to me. But I need people to show me what to do and to answer my questions so I can regain my independence and start to enjoy life again………………

Anon, Major Trauma Patient.