ORIGINAL ARTICLE

The casualty profile from the Reading train crash, November 2004: proposals for improved major incident reporting and the application of trauma scoring systems

N R Howells, N Dunne, S Reddy

Royal Berkshire Hospital, Reading, Berkshire, UK

Correspondence to:
Correspondence to:
Dr Nick R Howells
Department of Orthopaedics, Royal Berkshire Hospital, London Road, Reading RG1 5AN, UK; nickrhowells{at}yahoo.co.uk

Objective: To report the casualty profile of the major incident at the Royal Berkshire Hospital, Reading, following the Ufton Nervet Train crash, November 2004. To make further proposals regarding major incident reporting and implementation of trauma-scoring systems.

Method: Retrospective analysis of emergency department and hospital notes. Calculation of index Injury Severity Score (ISS) and Trauma and Injury Severity Score (TRISS) in all patients.

Results: Of 61 casualties, the majority (74%) were seen in the minors area of our emergency department with a mixture of blunt impact and penetrating glass injuries. One died and 16 were admitted. 10% had an ISS >16. All surviving patients had a TRISS predicted probability of survival >90%.

Conclusion: We propose mandatory major incident reporting within 6 months of a major incident to aid development of a national database. As previously proposed, this will aid education and facilitate future major incident planning. We further propose the widespread use of trauma scoring systems to facilitate comparative analysis between major incidents, perhaps extrapolating this to develop a major incident score.

Abbreviations: AIS, Abbreviated Injury Scale; GCS, Glasgow Coma Scale; ISS, Injury Severity Score; RTS, Revised Trauma Score; TRISS, Trauma and Injury Severity Score

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