The authors raise some very important issues regarding surgical
trauma care in the UK [1]. However I feel the problem runs much deeper
than this and within the organisation of trauma systems as a whole in this
country. Since as early as 1988 it has been recognised that there are
serious problems with the management of severely injured patients in the
UK [2]. Our American colleagues have developed trauma centres hospitals
graded on their ability to provide care for severely injured patients with
level II + III centres feeding the more severely injured to a centrally
located level I centre, capable of dealing with any multi-system trauma. A
system proved to save lives [3,4]. However in the UK, largely for
financial reasons we have not adopted this system. Instead we opt for a
much more haphazard model [4]. Is it not time that we addressed this long
overdue issue? I look forward to October 2007 and the findings of the
NCEPOD (National Confidential Enquiry into Patient Outcome and Death)
study of severely injured patients in the UK and its recommendations. I
also look forward to a day when there is more interest from all
specialties in Trauma in the UK. It is after all the leading killer of
our younger generations and a disease process responsible significant
national financial burden secondary to lost revenue, injury and medical
cost (in 1997) valued as £7,970 for a minor injury, £102,880 for a major
injury and £902,500 for a death [5].
References
1.Tai N. Ryan J. Brooks A. – The neglect of trauma surgery BMJ
2006;332:805-06
2.Report of the working party on the management of patients with major
injury, Royal College of Surgeons of England, London 1988
3.Chaira O Cimbanissi S - Organized trauma care: does volume matter and do
trauma centres save lives? Curr Opin Crit Care 2003; 9:510-4
4.Albert J. Phillips H. - Trauma care systems in the United Kingdom Injury
2003 Sep;34(9):728-34
5.Better care for the severely injured The Royal College of Surgeons of
England and The British orthopaedic Association, 2000 www.boa.ac.uk
Competing interests:
Unpaid organiser of the annual trauma medicine for medical student’s conference in London
Rapid Response:
The neglect of trauma systems
The authors raise some very important issues regarding surgical
trauma care in the UK [1]. However I feel the problem runs much deeper
than this and within the organisation of trauma systems as a whole in this
country. Since as early as 1988 it has been recognised that there are
serious problems with the management of severely injured patients in the
UK [2]. Our American colleagues have developed trauma centres hospitals
graded on their ability to provide care for severely injured patients with
level II + III centres feeding the more severely injured to a centrally
located level I centre, capable of dealing with any multi-system trauma. A
system proved to save lives [3,4]. However in the UK, largely for
financial reasons we have not adopted this system. Instead we opt for a
much more haphazard model [4]. Is it not time that we addressed this long
overdue issue? I look forward to October 2007 and the findings of the
NCEPOD (National Confidential Enquiry into Patient Outcome and Death)
study of severely injured patients in the UK and its recommendations. I
also look forward to a day when there is more interest from all
specialties in Trauma in the UK. It is after all the leading killer of
our younger generations and a disease process responsible significant
national financial burden secondary to lost revenue, injury and medical
cost (in 1997) valued as £7,970 for a minor injury, £102,880 for a major
injury and £902,500 for a death [5].
References
1.Tai N. Ryan J. Brooks A. – The neglect of trauma surgery BMJ
2006;332:805-06
2.Report of the working party on the management of patients with major
injury, Royal College of Surgeons of England, London 1988
3.Chaira O Cimbanissi S - Organized trauma care: does volume matter and do
trauma centres save lives? Curr Opin Crit Care 2003; 9:510-4
4.Albert J. Phillips H. - Trauma care systems in the United Kingdom Injury
2003 Sep;34(9):728-34
5.Better care for the severely injured The Royal College of Surgeons of
England and The British orthopaedic Association, 2000 www.boa.ac.uk
Competing interests:
Unpaid organiser of the annual trauma medicine for medical student’s conference in London
Competing interests: No competing interests