Background Major trauma guidelines specify that if the patient can be safely managed and the MTC can be reached within 45 minutes of leaving scene then the patient should be conveyed to the MTC. However, there is no evidence that supports the 45 minute timeframe. Given the rurality of the South West, an increase in the running time to the MTC to 60 minutes has been discussed amongst major trauma experts.
Method An audit was conducted to identify how many patients could benefit from an increase in running time to 60 minutes. The sample included all suspected major trauma patients identified between April 2013–March 2014 who were conveyed to the nearest trauma unit (TU). Travelling times to the TU and MTC were analysed. Patients were split into network areas to quantify the impact if any.
Results A maximum of 354 patients were identified as potentially benefitting from an increase to 60 minutes based on the travelling times to the TU and MTC. A minimum of 90 patients could have benefitted from an increase to 60 minutes. This was quantified by the patients who triggered the major trauma triage tool but were unable to reach the MTC in 45 minutes, and those confirmed by the Trauma Audit and Research Network (TARN) as having an ISS>15. The biggest impact would be seen in the Peninsula area where a total of 205 extra patients would be able to reach the MTC if the running time was increased.
Conclusion An increase in running time to 60 minutes to the MTC for patients in the South West could significantly improve the level of care that many patients receive in the first few hours following major trauma injuries. With the information available it is not possible to quantify the operational impact such a change would have.
- emergency department
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