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Contact Us | Email: [email protected] | Website: www.majortrauma.nzContact Us | Email: [email protected] | 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: [email protected] | Website: www.majortrauma.nzContact Us | Email: [email protected] | 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
