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temto day work environment trains them to be used to makingdecisions in time of crisis.

doi:10.1016/j.aenj.2011.09.019

6

ppropriate management to enable not only safe and timelyare for the patients but ensure best outcomes for the facil-ty. This session is highly relevant for all ED nurses in all areasf practice and level of experience.

oi:10.1016/j.aenj.2011.09.017

utcomes of severely injured adult trauma patients in anustralian health service. Does trauma centre level makedifference?

ate Curtis 1,2,7,8,∗, Shanley Chong3, Rebecca Mitchell 3,4,ark Newcombe5,6, Deborah Black9, Mary Langcake1

St George Hospital Trauma Department, Gray St, Kogarah,SW 2217, AustraliaSydney Nursing School, 88 Mallet St, University of Sydney,SW, AustraliaNSW Injury Risk Management Research Centre, Anzac Pde,niversity of NSW, NSW, AustraliaDepartment of Aviation, Anzac Pde, University of NSW,SW, AustraliaDepartment of Emergency Medicine, The Wollongong Hos-ital, Wollongong, NSW, AustraliaGreater Sydney Area HEMS, Bankstown, NSW, AustraliaSt George Clinical School, Faculty of Medicine, Universityf NSW, Gray St, Kogarah, NSW, AustraliaThe George Institute for Global Health L7, 341 George St,ydney, NSW, AustraliaFaculty of Health Sciences, University of Sydney, 75 Eastt, Lidcombe, NSW, Australiaeywords: Injury; Trauma; Patient outcomes; Australia;ospitals; Emergency; Quality improvement; Performance

mprovement

Background: Trauma centres are designated to provideystematised multidisciplinary care to injured patients.ffective trauma systems reduce patient mortality by facil-tating the treatment of injured patients at appropriatelyesourced hospitals. It has yet to be shown whether theres an outcome benefit associated with the ‘‘level of hospi-al’’ initially treating severely injured trauma patients inustralia

Aim: To determine whether the level of trauma cen-re providing treatment impacts mortality and/or hospitalength of stay.

Methods: Outcomes were evaluated for severely injuredrauma patients (Injury Severity Score >15) using NSW Insti-ute of Trauma and Injury Management data from 2002—2007or our regional health service. To assess associationsetween trauma centres and outcomes, a logistic regressionodel or multivariable linear regression model was used.

ex, age and ISS were included as covariates in all models.Results: There were 1986 trauma presentations during

he six year period. Patients presenting to a Level III traumaentre had a significantly higher risk of death than thoseresenting to the Level I centre. Peer review of deaths athe Level III centre identified problems in care delivery suchs technical errors, delay in decision making or errors of

udgement.

Conclusion: Severely injured patients treated at a LevelII centre had a higher mortality rate than those treated

P

t a Level I centre. Most problems identified occurred inhe ED and were related to delays in care provision. Thisesearch highlights the importance of efficient pre-hospital,n-hospital and regional trauma systems, performance mon-toring, peer review, and adherence to protocols anduidelines.

oi:10.1016/j.aenj.2011.09.018

o emergency nurses have a role in disaster deployments?

ngela Jackson1

Cairns Base Hospital, Department of Emergency Medicine,ueensland 4879, Australiaeywords: Disaster; Pakistan floods; Medical teams; Emer-ency nursing

-mail address: Angie-mark@bigpond.com.

Introduction: In July 2010 Pakistan floods began as aesult of heavy monsoon rains. This became the world’sargest humanitarian crisis with 20 million people beingffected, and 75% of those located in the Sindh and Punjabegions (OCHA 2 Dec 2010)

As part of the Australian whole of Government response,joint AusAID/Australian Defence Force (ADF) team were

eployed at the end of August. 180 ADF and civilian person-el deployed to the town of Kot Addu in the Punjab region.ivilian health professionals formed an AusMAT (Australianedical Assistance Team) and were embedded with the ADF.

Aim: The aim of this presentation is to describe the ben-fit of emergency nursing in a disaster environment withincivilian/military environment.Findings: A large component of the civilian team were

xperienced emergency nurses. The conditions in Pakistanere arduous with daytime temperatures on arrival of 47Cnd 90% humidity. We lived in tents and ate army rations. In5 days the team treated just under 11,500 patients, with3500 cases of malaria and 700 cases of diarrhoeal illness,

ncluding cholera. We resuscitated many sick children. Theverall success of this deployment was due to the experiencef the civilian team and in particular the emergency nursesnd physicians who are trained to deal with chaos and toork in unpredictable environments.

Conclusion: It is highly likely in the future that an AusMATeam will be asked to deploy again with the ADF. Experiencedmergency nurses should be included in any future deploy-ents because of their broad experience. Their chaotic day

1 Australian Medical Assistance Team (AusMAT) member Operationakistan Assist II 2010.