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tAbTpfhteria for helicopter emergency ambulance transfershould be reviewed and that changes be made to

108

autopsy records. Patient, injury and mortality datawere identified. Inclusion criteria were: normallyresident in Auckland, death or injury severity scoreof 16 or more and the injury occurring during thecalendar year (2004). Out of region patients wereexcluded. Census projection data was utilised toidentify the resident population by age group, gen-der and ethnicity.

Results: The annualised injury rate was 33.6 per100,000 population. Male injury and mortality rateswere three times those of female rates. Peaks inincidence were seen in the 15—29 and >75 year agegroups. Maori and Pacific (two ethnic sub-groups)had higher rates than the remaining population.Motor vehicle related injuries (occupant and pedes-trian) represented half of the injuries (50%).

Conclusions: Auckland has a relatively low inci-dence of major injury. Men, Maori and Pacific areover represented sub-groups of the population. Thetrends seen are similar to comparable studies.

Keywords: Population based; Major trauma

doi:10.1016/j.injury.2006.12.047

O23A dedicated trauma service reduces hospital stayin critically injured patients

R. Davenport ∗, A. West, M. Walsh, K. Brohi

Royal London Hospital, UK

Introduction: Seriously injured patients requirespecialist care and multidisciplinary input. In 2005the Royal London Hospital instituted a trauma ser-vice and dedicated ward to improve care deliveryand coordination for these patients. We hypoth-esized that a specialist trauma service improvesquality of care for trauma patients as measured byreduced length of stay.

Methods: A retrospective review of all traumapatients admitted over two 6-month periods beforeand after the institution of the trauma service.

Results: Three hundred and fifty trauma patientswere admitted in the first 6-months after institutionof the trauma service, compared with 300 admis-sions one year previously. Median injury severityscore was 9 in both groups. There was an overallreduction of one bed day per trauma patient. Totaltrauma bed days were reduced from 4680 to 4405.A maximal effect was observed in critically injuredpatients admitted to the intensive care unit (ICU),with a reduction in total stay from 22 to 13 days. On

average 2 days in ICU were saved per patient witha total saving of 145 ICU bed days, despite similarpatient numbers (90 versus 97) and injury severityscores (median 20 versus 18).

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Abstracts

Conclusions: Institution of a multidisciplinaryrauma service and co-localisation of traumaatients leads to early gains in hospital stay in crit-cally injured patients.

eywords: Trauma; Stay; Hospital; Critically

oi:10.1016/j.injury.2006.12.048

ESSION: POLYTRAUMA

24re-hospital patient transfer using helicoptermbulance: Should triage criteria be changed?

. Melton ∗, S. Jain, B. Kendrick, S. Deo

Great Western Hospital, UK

ntroduction: A retrospective review of all patientsransferred by helicopter ambulance to the Greatestern Hospital over a 20-month period between

anuary 2003 and September 2004 was undertakeno establish the case-mix of patients (trauma andon-trauma) transferred and the outcome.

Methods: Details of all Helicopter Emergencymbulance Service (HEAS) transfers to this unit

n the study time period from January 2003 toeptember 2004 were obtained from the three HEASroviders in the area and case notes were obtainednd reviewed. Patient case-mix, injury severity andhort to intermediate outcomes were collated. Wehen analysed the results.

Results: One hundred and fifty six traumaatients transferred (total 193). One hundred andleven cases identified for analysis with mean agef 33 years (range 1—92 years). Mean average injuryeverity score (ISS) on admission was 12 (range—36). 45 patients (41%) were discharged homeirectly from the emergency department. Twenty-our patients had operation, 10 patients requiredCU care and 2 were pronounced dead on arrival inhe Emergency department. Average hospital stayollowing HEAS transfer was 2.97 days (range 0—18).

Conclusion: Helicopter emergency ambulanceransfer in the acute setting is of debated value.lthough some studies have suggested a survivalenefit, this does not always seem to be the case.riage criteria are at fault if as many as 41% ofatients transferred are being discharged homerom casualty have incurred the financial cost ofelicopter transfer. We suggest that the triage cri-

nsure more appropriate use of a resource that isoth controversial and expensive.