NCEPOD: Trauma - Who Cares? - London Health Programmes

Summary of findingsThe organisation of prehospital care, the trauma teamresponse, seniority of staff involvement and immediate inhospitalcare was found to be defi cient in many cases.Lack of appreciation of severity of illness, of urgency ofclinical scenario and incorrect clinical decision making wereapparent. Many of these clinical issues were related to thelack of seniority and experience of the staff involved in theimmediate management of these patients.It was clear that the provision of suitably experienced staffduring evenings and nights was much lower than at othertimes. In the management of trauma, which very oftenpresents at night, this is a major concern. NHS Trustsshould be open about the differences in care by day andnight and look to address this as a matter of urgency. Publicawareness of these differences may be useful in any debateabout the future confi guration of trauma services.Severe trauma is not common and many hospitals see lessthan one severely injured patient per week. This has a directbearing on experience and ability to manage these challengingpatients. Not only does this relate to clinical skills but also tothe feasibility of providing the entire infrastructure required tomanage the trauma patient defi nitively in all centres.11