Northern Trauma System
Regional Conference 2014
High quality trauma care
from
‘Roadside to Recovery’
Map of region


North of region Trauma Network
– MTC – RVI
– TU
 WGH - Wansbeck
 NTGH - North Tyneside
 STGH - South Tyneside
 QEH – Gateshead
 SRI – Sunderland
 UHND – Durham
 Cumberland infirmary
South of region Trauma Network
–
–
RVI
MTC – JCUH
TU


JCUH
NTUH - North Tees
DMH - Darlington
NTS-CAG Trauma Triage Tool
Go – Live date April 1st 2012
Change in Receiving Hospital
Trauma Workload Pre and Post
Trauma Triage April to September
1200
1011
1000
934
800
MTC
TU
600
473
400
200
175
100
83
0
Pre April 12
Apr-Sept 12
Apr-Sept 13
Network Ws Score
2014-15


Network: hosting the Operational Delivery
Network
Pre hospital/ hospital Care:
– STOP the bleeding campaign; Management of
Traumatic haemorrhagic Shock
– Continue to develop protocols and checklists


Rehabilitation: Excellent review done April
2013 with recommendations. Its time for
action!!
Education, education, education…………….
The multidisciplinary Task Force for
Advanced Bleeding Care in Trauma was
formed in 2005
Search
 Treat
 Observe
 Prevent
The bleeding!!

Recommendation 1
We recommend that the time elapsed between injury and operation be minimised
for 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
Summary
‘train hard fight easy’
Clinical Director – Mr Andy Port
Trauma Lead – Dr Phil Godfrey
NEAS
NWAS
YAS
TARN admissions 2013
Major Trauma Centre services




ISS>8 – approx. 550 admissions per year
ISS>15 – approx. 250 admissions per year
Adult and paediatric
Single site for acute surgical services
–
–
–
–
–
–



Neuro
Cardio
Plastics
Ortho P&A / LL recon
Max fax
Spinal
24/7 ground level helipad at ED entrance
Daily MDT major trauma ward round
On-site regional spinal cord injury centre
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
120
100
90
80
70
60
50
40
30
20
10
0
100
80
60
40
20
0
11/12
Q3
11/12
Q4
12/13
Q1
12/13
Q2
12/13
Q3
12/13 13/14 13/14
Q4
Q1
Q2
MTC 06 - MTCs deliver consultant led trauma teams
ON ARRIVAL for patients with an ISS greater than 15
100
90
80
70
60
50
40
30
20
10
0
1
2
3
4
5
6
7
MTC 10 - Proportion of patients with GCS <9 with definitive
airway management within 30 minutes of arrival in ED
120
100
80
60
40
20
0
11/12
Q3
11/12
Q4
12/13
Q1
12/13
Q2
12/13
Q3
12/13 13/14 13/14
Q4
Q1
Q2
8
11/12
Q3
11/12
Q4
12/13
Q1
12/13
Q2
12/13
Q3
12/13
Q4
13/14
Q1
13/14
Q2
Mechanism ISS>15
Monthly admissions ISS>8
Network strengths







MDT case reviews/M&M
Network meetings
Honorary contracts for ED cons at MTC
TU peer reviews - NTS executive team
Regional governance system
PHEM training
Senior clinical engagement at MTC
– Daily MDT ward rounds
– Multidisciplinary case review
– Simulation, education and research



Strong military links
Spinal cord injury centre
TARN data
Northern Trauma
Karen Portas
system
Northern Clinical Networks and
Senate / March 2014
Northern Trauma System
NTS Exec Group
NTS CAG
MTC
MTC
RVI
James Cook
Wansbeck
Sunderland
Carlisle
Durham
Gateshead
N. Tyneside
S. Tyneside
Darlington
North
tees
North Tees
Recent achievements

Peer Review of Trauma Units
– Identified good practice
– Areas needing support or further input
– Focus work programme for next year

Rehabilitation
– Working group
– Recommendations from regional
report
– Working with other clinical networks
NHS | Presentation to Northern Trauma
Network Conference] | 28 March 2014
22
Plans for 2014
Standardising…
–Pathways, protocols, documentation
e.g. ATMIST, MHP, Trauma document
Improving
support for TARN
–Co-ordinators meeting joint with CAG
Risk
register
Rehabilitation
Website
NHS | Presentation to Northern Trauma Network Conference] | 28 March 2014
23
How to get involved
Clinical
Advisory Group
–Education and awareness
–Clinical consensus on regional issues
–Case reviews – incidents
–Data review/discussion
NHS | Presentation to Northern Trauma
Network Conference] | 28 March 2014
24