NCEPOD: Trauma - Who Cares? - London Health Programmes

2Organisational dataThere are some notable fi ndings in Table 15. Manyseverely injured patients require anaesthesia and trachealintubation. If already intubated in the prehospital phase,maintenance of anaesthesia will often be required. Despitethis, one in four hospitals reported that they did not haveanaesthetic machines in each bay and one in ten reportedthat they did not have ventilators. Rapid investigation ofpossible intraperitoneal haemorrhage is another essentialcomponent in the care of these patients. However, FocussedAssessment with Sonography for Trauma (FAST) was onlyavailable in 33.3% (61/183) of emergency departments anddiagnostic peritoneal lavage in 78.7% (144/183).In the 1993/1994 NCEPOD report, it was recommendedthat all acute hospitals should have a theatre that is kept freefrom elective surgery in the event that a patient requires anemergency procedure. Such emergency daytime theatresare often referred to as ‘NCEPOD theatres’. Table 16 showsthat 151/177 (85.3%) hospitals had a NCEPOD theatre, asignifi cant improvement on 1993/1994.Table 16. Number of hospitals with dedicated emergency and trauma theatresDedicated trauma theatreNCEPOD theatre Yes No Subtotal Not answered TotalYes 129 22 151 3 154No 10 16 26 1 27Subtotal 139 38 177 4 181Not answered 0 1 1 1 2Total 139 39 178 5 183Table 17. Number of consultants (whole time equivalents) by specialtyEmergencymedicineOrthopaedicsurgeonsGeneralsurgeonsVascularsurgeonsInterventionalradiologists0 3 6 2 43 51> 0 < 1 1 1 0 25 14≥ 1 < 2 16 2 3 43 32≥ 2 < 3 29 5 11 29 36≥ 3 < 4 47 7 16 24 21≥ 4 < 5 40 21 17 8 6≥ 5 < 6 21 30 31 1 8≥ 6 25 101 93 2 6Subtotal 182 173 173 175 174Not answered 1 10 10 8 9Total 183 183 183 183 18329