Major trauma means multiple, serious injuries that could result in death or serious disability. These might include serious head injuries, severe gunshot wounds or road traffic accidents.
These sorts of injury are actually quite rare and most hospital accident and emergency departments see fewer than one case of major trauma each week.
As major trauma is so uncommon, it is not possible for all hospitals to have the equipment and specialist doctors needed to treat it effectively.
For this reason, patients with multiple, serious injuries may need to be transferred to a major trauma centre. This is a hospital where they can be operated on immediately, if necessary, and where there is a full range of trauma specialists, including orthopaedics, neurosurgery and radiology teams. Care at major trauma centres is led by a trauma consultant, who is available 24 hours a day.
Patients who have suffered a severe injury often need complex reconstruction surgery and care from many professionals such as physiotherapists, occupational therapists and speech therapists.
This care is very important and many patients need a personalised rehabilitation programme taking many months to help them return to an active life. This care may take place at the major trauma centre or other units in the area.
What does good trauma care look like?
Good trauma care involves getting the patient to the right place at the right time for the right care. This means:
- Having the seriousness of the injury identified as early as possible, ideally at the scene of the incident.
- If this is not possible, investigations such as CT scanning should take place immediately on arrival at the first hospital.
- If the injury requires specialist care, the patient should be moved to a major trauma centre as quickly as possible.
- Patients should have access to an appropriate programme of rehabilitation to assist their recovery.
How the NHS is seeking to improve trauma care
An estimated 450 to 600 lives could be saved in NHS hospitals every year if trauma services were better organised.
To achieve this, the NHS is setting up regional trauma networks to ensure patients with serious and life-threatening injuries are treated quickly in a specialist hospital where expert staff are available round the clock. This programme will make big changes to existing ways of dealing with major trauma and the ways in which patients are admitted to hospital or referred for treatment. Around 20 major trauma centres are expected to be set up in England as part of the programme.
Some regions, such as East Midlands and London, have already gone a long way to providing operational regional trauma networks. The London Regional Trauma Network is available since 2010.
The Department of Health anticipates that regional trauma networks will be in place across the country by the end of 2011.
You can find out more about progress in your area from your strategic health authority.
