Table 1

Major incident patients presenting to emergency departments (ED)

All patientsAdults (>16 years)Children (<16 years)
No (%) 153 (100%) 109 (71%) 44 (29%)
Median (IQR) age in years36 (15–47)45 (34–50)13 (12–14)
No (%) of females107 (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-126 (17%)<5 (<3%)25 (16%)<5 (<3%)<5 (<3%%)0 (0%)
 MTC-28 (5%)5 (3%)8 (5%)5 (3%)0 (0%)0 (0%)
 MTC-38 (5%)5 (3%)8 (5%)5 (3%)0 (0%)0 (0%)
 P-MTC26 (17%)5 (3%)<5 (<3%)0 (0%)22 (14%)5 (3%)
 TU-114 (9%)0 (0%)10 (6%)0 (0%)<5 (<3%)0 (0%)
 TU-211 (7%)<5 (<3%)10 (6%)<5 (<3%%)<5 (<3%)0 (0%)
 TU-30 (0%)0 (0%)0 (0%)0 (0%)0 (0%)0 (0%)
 LEH-117 (11%)<5 (<3%)12 (8%)<5 (<3%)5 (3%)0 (0%)
 LEH-217 (11%)<5 (<3%)14 (9%)<5 (<3%)<5 (<3%)0 (0%)
 LEH-38 (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
 MTC6 (4%)0 (0%)<5 (<3%)0 (0%)<5 (<3%)0 (0%)
 Non-MTC9 (6%)0 (0%)7 (5%)0 (0%)<5 (<3%)0 (0%)
 Total153 (100%)24
(16%)
109
(71%)
19
(12%)
44
(29%)
5
(3%)
Mode of presentation to EDAll patients
(n=153)
Adults (>16 years)
(n=109)
Children (<16 years)
(n=44)
 No (%) by ambulance service59 (39%)43 (39%)16 (36%)
 No (%) by car57 (37%)38 (35%)19 (43%)
 No (%) walked<5 (<3%)<5 (<4%)0 (0%)
 No (%) not recorded33 (22%)24 (22 %) 9 (20%)
Median (IQR) Injury Severity overall and at MTCsOverall
(n=153)
MTC
(n=74)
Overall
(n=109)
MTC
(n=49)
Overall
(n=44)
MTC
(n=25)
 Median (IQR) ISS1 (1–10)7.5 (1–14)1 (1–10)6 (2–14)2 (1–9)5 (1–14)
 Median (IQR) NISS2 (1–14)10 (3–22)2 (1–14)9 (3–22)2 (1–14)10 (3–22)
 No (%) ISS 1–8104 (68%)37 (50%)71 (65%)23 (47%)33 (75%)14 (56%)
 No (%) ISS 9–1530 (20%)19 (26%)26 (24 %)15 (32%)<5 (<11%)<5 (<25 %)
 No (%) ISS >1519 (12%)18 (24%)12 (11.0%)11 (22.0%)7 (16 %)7 (28 %)
 No (%) NISS 1–898 (64%)32 (43%)68 (62%)21 43%)30 (68%)11 (44%)
 No (%) NISS 9–1518 (12%)12 (16%)14 (13 %)8 (16 %)<5 (<11%)4 (16 %)
 No (%) NISS >1537 (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 MTCsOverall
(n=153)
MTCs
(n=74)
Overall
(n=109)
MTCs
(n=49)
Overall
(n=44)
MTCs
(n=25)
 No (%)—head6 (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 (%)—chest12 (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 (%) —limbs32 (21%)21 (28%)26 (24 %)15 (31 %)6 (14 %)6 (24 %)
 No (%)—burns5 (3%)5 (7%)<5 (<5 %)<5 (<10 %)<5 (<11 %)<5 (<20 %)
Time before arrival in EDAll patients
(n=153)
Adults (>16 years)
(n=109)
Children (<16 years)
(n=44)
Median (IQR) minutes192 (94–287)187 (92–286)230 (95–285)
Patients arriving in ED within 6 hours by ISS
 No (%) ISS 1–878 (51%)53 (49%)25 (57%)
 No (%) ISS 9–1528 (18%)24 (22%)4 (9%)
 No (%) ISS >1518 (12%)11 (10%)7 (16%)
 Median (IQR) minutes before ED arrival ISS 1–8108 (70–242)105 (70–194)128 (91–270)
 Median (IQR) minutes before ED arrival ISS 9–15234 (180–255)230 (180–250)245 (236–255)
 Median (IQR) minutes before ED arrival ISS >15129 (101–196)125 (95–184)178 (133–246)
Time in ED
 Median (IQR) minutes151 (99–223)151 (109–240)158 (99–205)
First ED CT-scan
 No (%) requiring ED CT-scan41 (27%)35 (32%)6 (14%)
 Median (IQR) minutes to first ED CT-scan49 (25–82)49 (25–82)51 (47–55)
First surgical operation
 Median (IQR) minutes to first surgical operation558 (285–875)565 (285–893)536 (374–786)
Blood transfusion from ED arrival in first 24 hours
 No (%) requiring blood transfusion13 (8%)10 (9%)<5 (<11 %)
 Median (IQR) units used for those requiring blood transfusion1 (1–2)2 (2–4)1 (1–1)
ED disposition
 Died in ED (mortuary)<5 (<3%)<5 (<5 %)<5 (<11 %)
 Operating rooms21 (14%)18 (16%)<5 (<11 %)
 CC8 (5%)7 (6%)<5 (<11%)
 Inter-hospital transfer<5 (<3%)<5 (<5 %)<5(<11%)
 Hospital ward51 (33%)35 (32 %)16 (36%)
 Home60 (39%)39 (36%)21 (48 %)
 Incomplete records7 (5%)6 (5%)1 (2%)
 Total15310944
  • 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.