The National Trauma NetworkNational Major Trauma Clinical Network Committed to improving outcomes...

Contact Us | Email: info@majortrauma.nz | Website: www.majortrauma.nzContact Us | Email: help@majortrauma.nz | Website: www.majortrauma.nz

The National Trauma Network

Professor Ian Civil,

Clinical Leader

Major Trauma National Clinical Network

I

The Network is born

Surgeon to lead new trauma network

The MTNCN has three main priorities, which are

to:

Establish a formal trauma structure and system

across New Zealand

Establish the New Zealand Major Trauma

Registry

Develop consistent guidelines and plans for

managing trauma in New Zealand

WHAT IS MAJOR TRAUMA

NETWORK DEFINITION

• Death following injury

• Injury Severity Score >12

Transforming data into information

Cause of injury

Maori have the greatest burden of injury

12/100,000

15/100,000

17/100,000

12/100,000

Why do people die after trauma

Why do people die after trauma

Why do people die after trauma

Why do people die after trauma

What can we do about it?

• Destination decision

• Haemorrhage control

Destination policy

Regionalisation

Group

Time from

injury to

Acute supra-

regional SCI

centre

(Hours)

Time from

admission to

acute supra-

regional SCI

centre -

decompression

(Hours)

Time from

injury to

decompression

(Hours)

Time injury

to Spinal

Rehabilitatio

n admission

(Days)

Overall length

of stay (injury

to Spinal unit

discharge)

(Days)

Pre-policy Median (IQR)

9.47 (2.8-

28.8)

15.08 (7.3- 22.5) 18.8 (9.1-

38.7.0)

13 (8-41) 90 (62-173)

Post policy Median (IQR)

4.46 (1.9 –

11.5)

* p=0.019

8.27 (5.3 – 19.2) 15.8 9.4 – 27.5) 10 (5-25) 96 (55.8-125)

Time to decompression for the pre and post intervention groups

Serious Traumatic Brain Injury

Serious Traumatic Brain Injury

Out of Hospital Major Trauma Destination Policy

Haemorrhage

• Identification

•Notification

•Resuscitation

• Intervention

Identification

• Clinical judgement• Pulse

• Blood pressure

• Blood loss

• Mechanism of injury

• ABC score

Hard to identify if vitals not recorded

And hard to audit afterwards if data not available

And fewer recordings made for those with life-threatening haemorrhage who die

Life-threatening haemorrhage

• Penetrating torso injury or penetrating injury with significant external blood loss

• High energy exchange blunt injury

• Tachycardia>120bpm

• SBP<90mmHg

Notification

Resuscitation

Intervention

Multiple Organ Failure

Medical

International Benchmarking

Contact Us | Email: info@majortrauma.nz | Website: www.majortrauma.nzContact Us | Email: help@majortrauma.nz | Website: www.majortrauma.nz

National Major Trauma Clinical NetworkCommitted to improving outcomes for trauma patients in NZ

Focussing on haemorrhage control, serious TBI, and rehabilitation

Active in prehospital, hospital and rehab sectors