A report on major trauma has said that services need to be reorganised to ensure that patients are brought to the right hospital, for the right treatment, at the right time.
It reveals that just 8% of patients were received by a trauma team on arrival to hospital and 28% of patients had to be transferred to another hospital for ongoing care.
Major trauma services need to be reorganised, a new study has found pic.twitter.com/PcDsnGvOrh— RTÉ News (@rtenews) January 31, 2018
It found that the average age of major trauma patients is 55 and 40% are aged 65 years and older.
The 'Major Trauma Adult Summary Report 2016' has been published by the National Office of Clinical Audit.
Dr Conor Deasy, Clinical Lead for Major Trauma Audit at the NOCA, said the report highlights the need for change, as patients with major trauma are not being assessed by trauma teams and senior clinicians on arrival to emergency departments.
The audit says that older major trauma patients are more complex to treat, due to pre-existing health conditions.
They are also less likely to be reviewed by a senior clinician and were more likely to die and suffer high levels of disability than younger major trauma patients.
Older patients are less likely to be discharged home and are more likely to be discharged to rehabilitation, or long-term care, compared to younger patients.
Road trauma was the most common cause of injury in the younger age groups.
The report says that pre-hospital carers and emergency medicine professionals, should exercise a high level of suspicion of major trauma in older patients, with falls of less than two metres, for example.
The audit focuses on the care of the more severely injured patients in the health system, across 26 trauma receiving hospitals.
It calls for a definition of what should constitute a trauma team and activation criteria for such a team.
The review involved more than 4,400 patients.
The most common ways patients were injured were:
- 51% had a fall of less than 2m
- 18% suffered road trauma
- 13% had a fall of greater than 2m.
- Most injuries were in the home, amounting to 47% of the total.
The next most common area for injury was a public area and road at 39%. Most people injured a limb, their chest or abdomen, or head.
The audit also found that the median length of stay in hospital was nine days and that 96% of major trauma patients survived.
Speaking on RTÉ's Morning Ireland, Dr Deasy said it is clear that trauma care in Ireland needs to be reformed and that patients are being exposed to greater risks, including death, because of the way major trauma care is delivered.
He said the chances of survival are increased by 30% if patients are treated properly and that while heroic work is being done at hospitals, it should not take heroism to deliver standard, quality trauma care.