NCEPOD: Trauma - Who Cares? - London Health Programmes

CHAPTER 2 - Organisational dataTable 8. Availability of multiple 24 hour treatmentEmergencydepartmentEmergencydepartmentGeneralsurgeryEmergencydepartmentGeneralsurgeryOrthopaedictraumaEmergencydepartmentGeneralsurgeryOrthopaedictraumaVascularsurgeryEmergencydepartmentGeneralsurgeryOrthopaedictraumaVascularsurgeryNeurosurgeryEmergencydepartmentGeneralsurgeryOrthopaedictraumaVascularsurgeryCardiac orThoracicsurgery183 166 159 90 23 33 17EmergencydepartmentGeneralsurgeryOrthopaedictraumaVascularsurgeryNeurosurgeryCardiac orThoracicsurgeryTable 9. X-ray with immediate reporting by proximity to emergency department and 24 hour accessibility24 hour accessibilityProximity Yes No Subtotal Not answered TotalAdjacent 112 25 137 9 146Onsite not adjacent 15 7 22 1 23Offsite 0 2 2 0 2Subtotal 127 34 161 10 171Not answered 2 4 6 6 12Total 129 38 167 16 183The availability of multiple specialty treatment was furtheranalysed. It is clear from Table 8 that regional planning oftrauma services should consider the availability of servicesat each hospital and consider whether it is appropriate totake some severely injured patients to hospitals without afull range of services, available at all times. Only 17 hospitalsthat participated in this study could have been considered forLevel 1 verifi cation as a Trauma Centre (see Appendix E).Twenty four hour accessibility was defi ned as a facility whichcan be fully staffed and functional when required anytime ofday or night. Thirty four hospitals reported that they did nothave x-ray with immediate reporting meeting this defi nition(Table 9). Such a fundamental facility should be available atall times at every hospital that has the potential to receive aseverely injured patient.Whilst 161/169 (95.3%) hospitals had CT scanning thatmet the 24 hour defi nition, only 97/169 (57.4%) had thescanners located adjacent to the emergency department26