There are now more patients than ever in the south region surviving life-threatening trauma injuries thanks to the development of the regional trauma network and major trauma centre at Southampton General Hospital.
The network is part of a national system which went live nationwide in April 2012, and consists of 27 regional networks. Each network is made up of one designated trauma centre that’s supported by surrounding hospitals, known as trauma units.
Increasing survival chances
An independent report produced by the Trauma Audit and Research Network (TARN) in The Lancet’s EClinicalMedicine journal found that 1,656 additional lives have been saved in England since the launch. There were 61 lives in the south central region alone, showing an increase of nearly a fifth in the odds of survival from severe injury nationwide in the five years from 2012.
It also highlighted that changes including pre-hospital intubation, improved treatment for major bleeding and advances in emergency surgery techniques had led to a reduction in the number of patients needing critical care from 31% to 24%. Patients now also spend a day less on critical care wards.
Trauma in Southampton
Southampton General Hospital is one of only 11 centres across the country that offers the full range of specialist surgical, intensive care and supporting services for both adults and children who suffer major trauma which is the most common cause of death in children and adults under the age of 40.
More than half of all major trauma – the term used to describe life-threatening injuries commonly sustained through road traffic accidents, falls, violence or sporting injuries – happens on the road and it is twice as common in urban areas than rural parts of the country.
Latest TARN data for University Hospital Southampton NHS Foundation Trust, shows 4,009 patients were treated for life-threatening injuries between 2014 and 2017, with 3,668 survivors compared to an expected number of 3,641 based on the severity of their conditions.
Patients with major injuries across the region bypass their local hospitals to go directly to Southampton if their injury occurs within a 60-minute drive, while those injured further afield are taken to their nearest trauma unit and assessed and resuscitated before being rapidly transferred if they require specialist intervention.
The city's trauma centre is supported by six trauma units – Portsmouth, Basingstoke, Poole, Dorchester, Salisbury and St Mary’s Hospital on the Isle of Wight – as well as two ambulance services and the Hampshire and Isle of Wight Air Ambulance. These combine to make the Wessex Trauma Network.
“The launch of major trauma networks across England in 2012 was one of the most significant developments in the NHS in a generation,” said Professor Robert Crouch, deputy director of major trauma at UHS.
“It is estimated to take up to 10 years for a trauma system to 'mature' and reach its full potential, so to be at this milestone in terms of additional lives saved at the halfway point is an amazing achievement.”
Prof Crouch said education among clinicians on how different teams work, including projects on team psychology and behaviour led by consultant major trauma anaesthetist Dr Suzanne Kellett, were “integral” to the success of the network.
“We have made really important steps in improving survival from injury both nationally and locally, but a key area for future work should be education and injury prevention. Many of the injuries and ‘accidents’ that we deal with are preventable – we simply have to do more to prevent some of these unnecessary tragedies.”
Posted on Tuesday 21 August 2018