Northern Trauma Northern Trauma System Regional System Regional Conference 2014Conference 2014

High quality trauma care High quality trauma care from from ‘‘Roadside to Recovery’Roadside to Recovery’

RVI

JCUH

Map of regionMap of region North of region Trauma NetworkNorth of region Trauma Network

– MTC – RVIMTC – RVI– TUTU

WGH - WansbeckWGH - Wansbeck NTGH - North TynesideNTGH - North Tyneside STGH - South TynesideSTGH - South Tyneside QEH – GatesheadQEH – Gateshead SRI – SunderlandSRI – Sunderland UHND – DurhamUHND – Durham Cumberland infirmary Cumberland infirmary

South of region Trauma NetworkSouth of region Trauma Network– MTC – JCUHMTC – JCUH– TUTU

NTUH - North Tees NTUH - North Tees DMH - DarlingtonDMH - Darlington

NTS-CAG Trauma Triage ToolNTS-CAG Trauma Triage ToolGo – Live date April 1Go – Live date April 1stst 2012 2012

Change in Receiving Hospital Change in Receiving Hospital Trauma Workload Pre and Post Trauma Workload Pre and Post Trauma Triage April to Trauma Triage April to September September

175

473

934

100

1011

83

0

200

400

600

800

1000

1200

Pre April 12 Apr-Sept 12 Apr-Sept 13

MTC

TU

Network Ws ScoreNetwork Ws Score

2014-152014-15

Network: hosting the Operational Delivery Network: hosting the Operational Delivery NetworkNetwork

Pre hospital/ hospital Care: Pre hospital/ hospital Care: – STOPSTOP the bleeding campaign; Management of the bleeding campaign; Management of

Traumatic haemorrhagic ShockTraumatic haemorrhagic Shock– Continue to develop protocols and checklistsContinue to develop protocols and checklists

Rehabilitation: Excellent review done April Rehabilitation: Excellent review done April 2013 with recommendations. Its time for 2013 with recommendations. Its time for action!!action!!

Education, education, education…………….Education, education, education…………….

The multidisciplinary Task Force forAdvanced Bleeding Care in Trauma wasformed in 2005

SSearchearch TTreatreat OObservebserve PPrevent revent The bleeding!!The bleeding!!

Recommendation 1We recommend that the time elapsed between injury and operation be

minimisedfor patients in need of urgent surgical bleeding control. (Grade 1A)

Spahn et el: Management of bleeding and coagulopathy followingmajor

trauma: an updated European guideline Critical Care 2013, 17:R76

Questions Questions

Summary Summary

‘‘train hard fight easy’train hard fight easy’

Clinical Director – Mr Andy PortClinical Director – Mr Andy Port

Trauma Lead – Dr Phil GodfreyTrauma Lead – Dr Phil Godfrey

NEAS

YAS

NWAS

TARN admissions 2013TARN admissions 2013

ISS>8 – approx. 550 admissions per yearISS>8 – approx. 550 admissions per year ISS>15 – approx. 250 admissions per year ISS>15 – approx. 250 admissions per year Adult and paediatricAdult and paediatric Single site for acute surgical servicesSingle site for acute surgical services

– NeuroNeuro– CardioCardio– PlasticsPlastics– Ortho P&A / LL reconOrtho P&A / LL recon– Max faxMax fax– SpinalSpinal

24/7 ground level helipad at ED entrance24/7 ground level helipad at ED entrance Daily MDT major trauma ward roundDaily MDT major trauma ward round On-site regional spinal cord injury centreOn-site regional spinal cord injury centre

Major Trauma Centre Major Trauma Centre servicesservices

MTC03 - Proportion of patients meeting NICE head injury guidelines that receive CT scan within 60 minutes of

arrival at MTC

MTC04 - MTCs deliver definitive cover of open fractures within BOAST 4 guidelines

MTC 06 - MTCs deliver consultant led trauma teams ON ARRIVAL for patients with an ISS greater than 15

MTC 10 - Proportion of patients with GCS <9 with definitive airway management within 30 minutes of arrival in ED

Mechanism ISS>15Mechanism ISS>15

Monthly admissions Monthly admissions ISS>8ISS>8

MDT case reviews/M&MMDT case reviews/M&M Network meetings Network meetings Honorary contracts for ED cons at MTCHonorary contracts for ED cons at MTC TU peer reviews - NTS executive teamTU peer reviews - NTS executive team Regional governance systemRegional governance system PHEM trainingPHEM training Senior clinical engagement at MTC Senior clinical engagement at MTC

– Daily MDT ward roundsDaily MDT ward rounds– Multidisciplinary case reviewMultidisciplinary case review– Simulation, education and researchSimulation, education and research

Strong military linksStrong military links Spinal cord injury centreSpinal cord injury centre TARN dataTARN data

Network strengthsNetwork strengths

Northern Trauma Northern Trauma systemsystemKaren PortasKaren Portas

Northern Clinical Networks Northern Clinical Networks and Senate / March 2014and Senate / March 2014

Northern Trauma System

Recent achievementsRecent achievements

Peer Review of Trauma UnitsPeer Review of Trauma Units– Identified good practiceIdentified good practice– Areas needing support or further inputAreas needing support or further input– Focus work programme for next yearFocus work programme for next year

Rehabilitation Rehabilitation – Working groupWorking group– Recommendations from regional reportRecommendations from regional report– Working with other clinical networksWorking with other clinical networks

NHS | Presentation to Northern Trauma NHS | Presentation to Northern Trauma Network Conference] | 28 March 2014Network Conference] | 28 March 2014

2222

Plans for 2014Plans for 2014

Standardising…Standardising…– Pathways, protocols, documentation e.g. Pathways, protocols, documentation e.g.

ATMIST, MHP, Trauma documentATMIST, MHP, Trauma documentImproving support for TARNImproving support for TARN– Co-ordinators meeting joint with CAGCo-ordinators meeting joint with CAG

Risk registerRisk registerRehabilitationRehabilitationWebsiteWebsite

2323NHS | Presentation to Northern Trauma Network Conference] | 28 March 2014

How to get involvedHow to get involved

Clinical Advisory GroupClinical Advisory Group–Education and awarenessEducation and awareness–Clinical consensus on regional Clinical consensus on regional

issuesissues–Case reviews – incidentsCase reviews – incidents–Data review/discussionData review/discussion

2424NHS | Presentation to Northern Trauma NHS | Presentation to Northern Trauma Network Conference] | 28 March 2014Network Conference] | 28 March 2014