Saving lives, limbs and livelihoods: considerations in restructuring a national trauma service.
Ir J Med Sci
; 184(3): 659-66, 2015 Sep.
Article
en En
| MEDLINE
| ID: mdl-25481642
ABSTRACT
STUDY HYPOTHESIS:
Level 1 trauma centers reduce mortality and improve functional outcomes in major trauma. Despite this, many countries, including Ireland, do not have officially designated major trauma centers (MTC). This study aimed to examine international trauma systems, and determine how to "best fit" trauma care in a small country (Ireland) to international models.METHODS:
The literature was reviewed to examine international models of trauma systems. An estimate of Irish trauma burden and distribution was made using data from the Road Safety Authority (RSA) on serious or fatal RTAs. Models of a restructured trauma service were constructed and compared with international best practice.RESULTS:
Internationally, a major trauma center surrounded by a regional trauma network has emerged as the gold standard in trauma care. In Ireland, there are no nationally coordinated trauma networks and care is provided by 26 acute hospitals with a mean distance to hospital from RTAs of 20.6 km ± 15.6. Based on our population, Ireland needs two Level 1 MTCs (in the two areas of major population density in the east and south), with robust surrounding trauma networks including Level 2 or 3 trauma centers. With this model, the estimated mean number of cases per Level 1 MTC per year would be 628, with a mean distance to MTC of 80.5 ± 59.2 km, (maximum distance 263.5 km).CONCLUSION:
Clearly designated and adequately resourced MTCs with trauma networks are needed to improve trauma outcomes, with concomitant investment in pre-hospital infrastructure.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Centros Traumatológicos
/
Heridas y Lesiones
/
Traumatismo Múltiple
Tipo de estudio:
Guideline
Límite:
Humans
País/Región como asunto:
Europa
Idioma:
En
Revista:
Ir J Med Sci
Año:
2015
Tipo del documento:
Article