As major trauma is so uncommon, it is not possible for all hospitals to have the equipment and specialist doctors needed to treat it effectively. For this reason, patients with multiple, serious injuries may need to be transferred to a major trauma centre. This is a hospital where they can be operated on immediately, if necessary, and where there is a full range of trauma specialists, including orthopaedics, neurosurgery and radiology teams. Care at major trauma centres is led by a trauma consultant, who is available 24 hours a day.
Patients who have suffered a severe injury often need complex reconstruction surgery and care from many professionals such as physiotherapists, occupational therapists and speech therapists.
This care is very important and many patients need a personalised rehabilitation programme taking many months to help them return to an active life. This care may take place at the major trauma centre or other units in the area.
Due to the historical set up in Cheshire and Mersey where specialist services have been spread across a number of Trusts a collaborative approach was required. Patients who have been incorrectly triaged or have self- presented at a Trauma Unit (TU) with serious injury which exceeds the resources and capability of the TU will be rapidly transferred to an MTC. In addition, some patients will need treatment in the MTC (for example for pelvic fracture surgery) which will require transfer in within the first 2 days following injury.
There are three types of MTC – those that treat only adults, those that treat only children and those who can treat both adults and children. Cheshire and Mersey have a major trauma centre that only treats children at Alder Hey Children's Hospital NHS Foundation Trust, and one adult MTC receiving site at Aintree University Hospital NHS Foundation Trust and linked to the Walton Centre NHS Foundation Trust that cares for all patients requiring neurosurgery. The service is designed to deliver high quality specialist care to patients of all ages starting from admission to the relevant MTC, with full assessment and diagnostics in the emergency department. This may be followed by operative treatment and an episode in the critical care unit and ward. Rehabilitation is required for a number for patients, and this rehabilitation will start in the MTC and continue through specialist rehabilitation units or locally through a variety of commissioned providers defined in the network.
Quality measures aim to find the most appropriate and deliverable measures that can be used nationally to help organisations improve the quality of care in their services.
This section contains details of existing training opportunities available to staff groups within the trauma pathway.
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