All patients | Adults (>16 years) | Children (<16 years) | ||||
No (%) | 153 (100%) | 109 (71%) | 44 (29%) | |||
Median (IQR) age in years | 36 (15–47) | 45 (34–50) | 13 (12–14) | |||
No (%) of females | 107 (70%) | 68 (62%) | 40 (91%) | |||
No (%) of all ED patient arrivals and no requiring critical care (CC) | ED | CC | ED | CC | ED | CC |
GM Major Trauma Care System | ||||||
MTC-1 | 26 (17%) | <5 (<3%) | 25 (16%) | <5 (<3%) | <5 (<3%%) | 0 (0%) |
MTC-2 | 8 (5%) | 5 (3%) | 8 (5%) | 5 (3%) | 0 (0%) | 0 (0%) |
MTC-3 | 8 (5%) | 5 (3%) | 8 (5%) | 5 (3%) | 0 (0%) | 0 (0%) |
P-MTC | 26 (17%) | 5 (3%) | <5 (<3%) | 0 (0%) | 22 (14%) | 5 (3%) |
TU-1 | 14 (9%) | 0 (0%) | 10 (6%) | 0 (0%) | <5 (<3%) | 0 (0%) |
TU-2 | 11 (7%) | <5 (<3%) | 10 (6%) | <5 (<3%%) | <5 (<3%) | 0 (0%) |
TU-3 | 0 (0%) | 0 (0%) | 0 (0%) | 0 (0%) | 0 (0%) | 0 (0%) |
LEH-1 | 17 (11%) | <5 (<3%) | 12 (8%) | <5 (<3%) | 5 (3%) | 0 (0%) |
LEH-2 | 17 (11%) | <5 (<3%) | 14 (9%) | <5 (<3%) | <5 (<3%) | 0 (0%) |
LEH-3 | 8 (5%) | 0 (0%) | 5 (3%) | 0 (0%) | <5 (<3%) | 0 (0%) |
LEH-4 | <5 (<3%) | 0 (0%) | <5 (<3%) | 0 (0%) | <5 (<3%) | 0 (0%) |
Outside GM Major Trauma Care System | ||||||
MTC | 6 (4%) | 0 (0%) | <5 (<3%) | 0 (0%) | <5 (<3%) | 0 (0%) |
Non-MTC | 9 (6%) | 0 (0%) | 7 (5%) | 0 (0%) | <5 (<3%) | 0 (0%) |
Total | 153 (100%) | 24 (16%) | 109 (71%) | 19 (12%) | 44 (29%) | 5 (3%) |
Mode of presentation to ED | All patients (n=153) | Adults (>16 years) (n=109) | Children (<16 years) (n=44) | |||
No (%) by ambulance service | 59 (39%) | 43 (39%) | 16 (36%) | |||
No (%) by car | 57 (37%) | 38 (35%) | 19 (43%) | |||
No (%) walked | <5 (<3%) | <5 (<4%) | 0 (0%) | |||
No (%) not recorded | 33 (22%) | 24 (22 %) | 9 (20%) | |||
Median (IQR) Injury Severity overall and at MTCs | Overall (n=153) | MTC (n=74) | Overall (n=109) | MTC (n=49) | Overall (n=44) | MTC (n=25) |
Median (IQR) ISS | 1 (1–10) | 7.5 (1–14) | 1 (1–10) | 6 (2–14) | 2 (1–9) | 5 (1–14) |
Median (IQR) NISS | 2 (1–14) | 10 (3–22) | 2 (1–14) | 9 (3–22) | 2 (1–14) | 10 (3–22) |
No (%) ISS 1–8 | 104 (68%) | 37 (50%) | 71 (65%) | 23 (47%) | 33 (75%) | 14 (56%) |
No (%) ISS 9–15 | 30 (20%) | 19 (26%) | 26 (24 %) | 15 (32%) | <5 (<11%) | <5 (<25 %) |
No (%) ISS >15 | 19 (12%) | 18 (24%) | 12 (11.0%) | 11 (22.0%) | 7 (16 %) | 7 (28 %) |
No (%) NISS 1–8 | 98 (64%) | 32 (43%) | 68 (62%) | 21 43%) | 30 (68%) | 11 (44%) |
No (%) NISS 9–15 | 18 (12%) | 12 (16%) | 14 (13 %) | 8 (16 %) | <5 (<11%) | 4 (16 %) |
No (%) NISS >15 | 37 (24%) | 30 (40%) | 27 (25 %) | 20 (41 %) | 10 (23 %) | 10 (40%) |
No (%) of patients with major injuries by body region (AIS >3) overall and at MTCs | Overall (n=153) | MTCs (n=74) | Overall (n=109) | MTCs (n=49) | Overall (n=44) | MTCs (n=25) |
No (%)—head | 6 (4%) | 6 (8%) | <5 (<5 %) | <5 (<10%) | <5 (<11%) | <5 (<20 %) |
No (%)—face | <5 (<3%) | <5 (<7%) | <5 (<5 %) | <5 (<10%) | 0 (0%) | 0 (0%) |
No (%)—chest | 12 (8%) | 10 (13%) | 7 (6%) | 5 (10 %) | 5 (11%) | 5 (20 %) |
No (%)—abdomen | <5 (<3%) | <5 (<7%) | <5 (<5 %) | <5 (<10%) | <5 (<11%) | <5 (<20%) |
No (%)—spine | <5 (<3%) | <5 (<7%) | <5 (<5 %) | <5 (<10%) | 0 (0%) | 0 (0%) |
No (%)—pelvis | <5 (<3%) | 0 (0%) | <5 (<5 %) | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) |
No (%) —limbs | 32 (21%) | 21 (28%) | 26 (24 %) | 15 (31 %) | 6 (14 %) | 6 (24 %) |
No (%)—burns | 5 (3%) | 5 (7%) | <5 (<5 %) | <5 (<10 %) | <5 (<11 %) | <5 (<20 %) |
Time before arrival in ED | All patients (n=153) | Adults (>16 years) (n=109) | Children (<16 years) (n=44) | |||
Median (IQR) minutes | 192 (94–287) | 187 (92–286) | 230 (95–285) | |||
Patients arriving in ED within 6 hours by ISS | ||||||
No (%) ISS 1–8 | 78 (51%) | 53 (49%) | 25 (57%) | |||
No (%) ISS 9–15 | 28 (18%) | 24 (22%) | 4 (9%) | |||
No (%) ISS >15 | 18 (12%) | 11 (10%) | 7 (16%) | |||
Median (IQR) minutes before ED arrival ISS 1–8 | 108 (70–242) | 105 (70–194) | 128 (91–270) | |||
Median (IQR) minutes before ED arrival ISS 9–15 | 234 (180–255) | 230 (180–250) | 245 (236–255) | |||
Median (IQR) minutes before ED arrival ISS >15 | 129 (101–196) | 125 (95–184) | 178 (133–246) | |||
Time in ED | ||||||
Median (IQR) minutes | 151 (99–223) | 151 (109–240) | 158 (99–205) | |||
First ED CT-scan | ||||||
No (%) requiring ED CT-scan | 41 (27%) | 35 (32%) | 6 (14%) | |||
Median (IQR) minutes to first ED CT-scan | 49 (25–82) | 49 (25–82) | 51 (47–55) | |||
First surgical operation | ||||||
Median (IQR) minutes to first surgical operation | 558 (285–875) | 565 (285–893) | 536 (374–786) | |||
Blood transfusion from ED arrival in first 24 hours | ||||||
No (%) requiring blood transfusion | 13 (8%) | 10 (9%) | <5 (<11 %) | |||
Median (IQR) units used for those requiring blood transfusion | 1 (1–2) | 2 (2–4) | 1 (1–1) | |||
ED disposition | ||||||
Died in ED (mortuary) | <5 (<3%) | <5 (<5 %) | <5 (<11 %) | |||
Operating rooms | 21 (14%) | 18 (16%) | <5 (<11 %) | |||
CC | 8 (5%) | 7 (6%) | <5 (<11%) | |||
Inter-hospital transfer | <5 (<3%) | <5 (<5 %) | <5(<11%) | |||
Hospital ward | 51 (33%) | 35 (32 %) | 16 (36%) | |||
Home | 60 (39%) | 39 (36%) | 21 (48 %) | |||
Incomplete records | 7 (5%) | 6 (5%) | 1 (2%) | |||
Total | 153 | 109 | 44 |
Table 1 summarises demographic, patient dispersal, management and disposition information about major incident patients presenting to their original ED. Duplications resulting from any subsequent secondary inter-hospital transfer have been corrected for in these data. Primary receiving hospitals included MTC, a P-MTC, TU and LEH across GM and elsewhere in the UK. A Major Trauma Centre is the UK equivalent of a level-1 Trauma Centre in North America; a Trauma Unit is the equivalent of level-2 and a Local Emergency Hospital is level-3. Patient numbers requiring CC at each centre are indicated. Injury severity is summarised using the ISS and the NISS. Major injury by body region is summarised using the AIS. Population data include counts, percentages, medians and IQR as appropriate. Medians and IQR for systolic blood pressure, respiratory rate and Glasgow Coma Score on arrival in the ED are not presented due to the large amount of missing data (see figure 1).
AIS, Abbreviated Injury Severity Score; GM, Greater Manchester; ISS, Injury Severity Score; LEH, local emergency hospitals; MTC, major trauma centres; NISS, new ISS; P-MTC, paediatric MTC; TU, trauma units.