NCEPOD: Trauma - Who Cares? - London Health Programmes

2Organisational dataTable 20. Number of consultants who had a specialist interest in traumaOrthopaedicsurgeonsGeneralsurgeonsVascularsurgeonsInterventionalvascular radiologists0 66 137 128 1231 25 10 13 122 9 5 6 103 9 5 2 44 9 1 3 25 7 3 0 0≥ 6 39 6 0 0Subtotal 164 167 152 151Not answered 19 16 31 32Total 183 183 183 183The management of trauma patients requires amultidisciplinary approach. However, at the time of this studythere was a lack of specialist interest in trauma across thespecialties (Table 20). This may well be a refl ection of thelow trauma workload which makes it diffi cult to developand maintain a special interest in this area, given the currentconfi guration of trauma services.To explore the apparent lack of specifi c consultant interest intrauma further, we looked at the 33 hospitals that performedneurosurgical procedures at all times. Table 21 demonstratesthat even in those hospitals with neurosurgery, other thaninterest from orthopaedic surgeons there was little specialistinterest in trauma. This is important as it has been proposedthat hospitals with neurosurgery could form the basis ofregional trauma centres 2 .Table 22 illustrates the number of hospitals which had aformal trauma team and whether or not ATLS courses wererun onsite. One hundred and forty three hospitals (78.1%)had a formal trauma team, and 82 (44.8%) indicated thatthey ran ATLS courses onsite. It is diffi cult to comprehendthe fi nding that 16 hospitals that ran ATLS courses did nothave a formal trauma team; a key component of ATLS.Table 21. Hospitals that perform neurosurgicalprocedures at all times and consultants with aspecialist interest in traumaNumber ofhospitalsOrthopaedic surgeons 24General surgeons 5Vascular surgeons 6Vascular interventional radiologists 5Table 22. Formal trauma team/responseassociated with an ATLS course run onsiteFormal trauma teamATLS courses Yes No TotalYes 66 16 82No 77 24 101Total 143 40 18331