TEN (Trauma East News) Check out what we've been up to |
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Welcome to our newsletter! You are among the first to hear the most important news and updates happening across the East of England Trauma Network. Newsletters will be issued every two months. (Volume 2 / Issue 1) |
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What you need to know about TTEC course The Trauma Team Essentials Course (TTEC) aims to provide you with the knowledge and skills to become an effective member of the trauma team. This 1-day course has been designed for all members of the trauma team working in the East of England. Content is based on TEMPO guidelines, and is mapped to the National Major Trauma Nursing Group Level 1 Competencies. The course takes the form of a series of lectures, workshops and practical scenarios, all designed to develop your technical and non-technical skills in relation to trauma care and team working. The main purpose of the course is to focus on, and rehearse, TEAM working. By firstly learning about team behaviours, effective team working and dynamics, you will then be given the opportunity to work in teams to put into practice both technical and non-technical skills in a series of challenging clinical scenarios. You will also learn about how the Trauma Network functions, and how your Trauma Unit fits into the pathway. By effectively training our trauma teams, we can ensure our trauma patients receive the best care, and improve outcomes across the region. The course is delivered in-house across the Trauma Units, with supportive and knowledgeable local faculty. To find out more about the TTEC, please contact your Trust Trauma Lead Consultant, or Sian Cross (Network Education Lead).
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New escalation document Following the retirement of the Trauma Network Divert Policy in 2020 we supported the direction taken by the National Trauma Network in formulating a Major Trauma specific Operational Pressures Escalation Levels, known as ‘Trauma-OPEL’ or ‘T-OPEL’ to support a fair and equitable escalation process for services providing acute trauma care across our region. The new T-OPEL is integrated within the ‘East of England Major Trauma Operational Delivery Network Escalation Process’ document which has been approved for use in the East of England by NHSE/I, with input and comments incorporated from the regional EPRR team and each of the Major Trauma Leads at each acute hospital within the East of England and the East of England Ambulance Service. |
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The escalation process document was published on 25th February 2021 and is available in digital format here or can be downloaded from our website. The document aim is to outline the roles and responsibilities of system partners at various escalation points ensuring minimal disruption to Major Trauma services and impact for patients. It outlines roles and responsibilities for stakeholders at various escalation phases, formalises existing actions and communication routes and provides a support tool for de-escalation. For further information please contact Simon Lewis (Clinical Director) or Matt Targett (Network Manager) |
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National DoS In February 2021 the National Trauma Network undertook a project supported by NHSE/I to improve the monitoring and support of regional trauma networks with a national Directory of Services (DoS). The DoS is an online situation reporting system (Sitrep) that is used by Major Trauma teams/acute hospitals and commissioners to monitor Trauma Unit (TU) and Major Trauma Centre (MTC) demand across the country. It will be the responsibility of each acute hospital’s operational teams to ensure data is input each morning. The DoS brings local reporting and support for acute hospitals and Trauma Networks in line with the Critical Care Network, allowing for rapid support and mutual aid considerations from the regional team, national team and NHSE/I. |
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The new DoS will become the sole location for data entry for hospitals, replacing our regional ‘Network Status’ website. There will be no change to the data entry location for pre-hospital services while NHSE/I develop this into the DoS For information on how to register and/or use the DoS please contact Matt Targett (Network Manager) or Kitti Czegledi (Network Administrator) Required data entry questions for a TU shown below. |
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Covid-19 Update Since our last update we are pleased to say that in the East of England, the number of Covid-19 cases requiring hospitalisation has fallen, with less requiring Intensive care input. Positively numbers of patients in ITU with Non-covid are beginning to exceed the numbers of patients confirmed to be Covid positive. |
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Despite the prevalence of Covid-19 reducing across the East of England some ‘hot spots’ within the region remain, and the need for appropriate social distancing and PPE precautions also remain. Please don’t forget that trauma patients, particularly those that have a reduced GCS, may be infected and appropriate PPE is needed until test results are confirmed – If in doubt wear your PPE. Although the worst of the usual winter pressures has begun to decline, non-covid trauma activity did not reduce as much as in the first national lockdown, this contributed to clinical and operation pressures remaining high in all of the hospital, pre-hospital trauma services. |
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While many hospitals in the region begin their restorative phases of this Covid wave we must remain vigilant to the risk it poses to our patients, families, colleagues and ourselves. Thank you for continuing to care for major trauma patients. Please make sure that you stay safe, look after yourselves and your loved ones. |
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Meet Sian, our Network Education Lead My name is Sian Cross, and I am the Education Lead for the Trauma Network. I am a nurse by profession, and my clinical background is in emergency nursing. On completing my nursing degree in 2003 at the University of Liverpool, I moved to London. I was fortunate enough to be offered a rotational post at Barts and The London NHS Trust (now Barts Health), and following two 6 month rotations in head and neck surgery and theatre recovery, I commenced the final rotation in my chosen specialty of A&E. I immediately loved it, and following the 6-month rotation elected to stay permanently. Whilst working at The Royal London Hospital, I developed a passion for trauma and gained valuable experience and education. After just over 5 years, I achieved my goal of becoming a Senior Sister. |
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After many years in London, I decided it was time for a change, and moved to the John Radcliffe Hospital in Oxford as an ED Senior Sister. This was short lived however, and due to my husband being relocated to Colchester, we moved to Suffolk and I was lucky enough to get a post in Addenbrookes ED as a Senior Sister. Working at Addenbrookes, and in Oxford, gave me a very different perspective of trauma outside of London, and the different challenges it presents. In 2018, an opportunity arose to join the Trauma Network on a 12-month secondment as the Education Lead. This job immediately appealed to me, and when the post became permanent I was in no doubt that I wanted to stay! I have enjoyed learning about the trauma pathway beyond the ED, and making many good working relations across the region. |
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Whilst still at university in 2002, I joined the Army Reserves as an Officer Cadet. The following year I commissioned into Queen Alexandra’s Royal Army Nursing Corps as a 2nd Lieutenant and still serve now as a Captain. During my time as an Army Reservist, I have completed two operational tours of Afghanistan as an Emergency Nurse, both of which provided me with a huge amount of trauma experience, and many personal and professional challenges. I have also taken part in oversees exercises, travelling to Canada, the USA, Gibralter, Cyprus, and the Netherlands, and have been fortunate enough to take part in many adventurous training activities, my favourite being learning how to snowboard in Austria! I am originally from the Bedford area, and so after living in Liverpool, London and Oxford, it has been great to come back to the East of England and to work for the Trauma Network. I look forward to continuing the work of the Network and strengthening trauma education across the region. |
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It's here! Directory of Rehabilitation Services - New edition available We are pleased to let you know, that the new edition of the Directory of Rehabilitation Services (DoS) is now available on our website. Thank you so much for all services who reviewed their entry or listed a new one. If you would like to get more information on how to enlist in the Directory, please contact Helen Young (Trauma Rehabilitation Co-ordinator) or Kitti Czegledi (Network Administrator). | | |
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Emergency Preparedness, Resilience and Response (EPRR) The EPRR framework (2015) was developed to enable the NHS to respond to a wide range of incidents and emergencies. Such emergencies range from terror attacks to adverse weather situations, and include an outbreak of infectious disease. In late December 2020, Essex declared a Major Incident in relation to capacity at its acute hospitals, in relation to the rising numbers of admissions of patients with COVID-19 (corona virus). In response to this declaration, the East of England (EoE) Trauma Network instigated their own regional EPRR process for Rehabilitation. The EPRR for Rehabilitation is a specific response identified by the British Society of Rehabilitation Medicine (BSRM). The BSRM identified that in order to support patient flow and help to optimise capacity in the acute settings, a ‘pull’ through of patients in to, or our of, rehabilitation settings was needed. Regionally this response needs participation from specific parties: - CCGs – All EoE CCGs were contacted to advise that the EPRR for rehabilitation had been initiated, and that they may be approached to assist with rapid placement/movement of patients.
For the EoE there are 2 CCGs in Bedfordshire, 1 in Cambridgeshire, 3 in Essex (although we also link to 4 other Essex CCGs on our periphery), 2 in Hertfordshire, 1 in Norfolk (a recent amalgamation of al 5 Norfolk CCGs to form 1), and 2 in Suffolk. Each of the CCGs has an identified person or team who acts as a ‘Neuro Navigator’ or ‘Complex Case Manager’. The rehab team of the Trauma Network always links very closely with these specific personnel. |
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2. Specialist Nursing Homes – in the EoE there is a lack of specialist inpatient rehabilitation formally accredited (by UKROC). The NCASRI report (2019) identified the East of England as the poorest served area in the UK per population. Due to this, the Trauma Network rehab team has worked closely with nursing homes who expressed interest to develop in the area of neuro rehabilitation, and there are now homes that are identified as ‘Specialist Nursing Homes’ (as per BSRM guidelines) for neuro rehabilitation. These homes were contacted as part of the EPRR for rehabilitation and asked to declare their COVID status and their bed status, to enable this to be shared with commissioners looking for rehabilitation beds. 3. Level 1/2a inpatient rehabilitation units and Spinal Cord Injury Centres. The EoE has one Level 1 unit – The Colman Centre for Specialist Rehabilitation in Norwich. The region also refers to Level 1/2a units in London, and a Level 1 setting in Leamington Spa. The EoE does not have a Spinal Cord Injury Centre (SCIC). At present, due to geography of the region, the EoE links with two SCICs – The National Spinal Injury Centre at Stoke Mandeville, and The Princess Royal Spinal Injury Centre at Sheffield. For the EPRR rehab response, all units were contacted to see if they had any EoE patients who could or should be moved out of the units. This exercise proved successful and was extremely well received across the region. All parties contacted engaged with the process and worked together for the benefit of the patient group. |
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Improving CT scanning for children CT scanning is a key component in the ED care of major trauma patients. However, there is a significant radiation dose associated. Guidelines in TEMPO and from NICE 2016 recommend a different protocol for children in order to reduce radiation doses and maximise information. An audit of cases from 2019 showed new need to be better in following the guidance, with many getting a CT Chest instead of the recommended x-ray. Of all the CT chest scans done for non-penetrating injury, there were no positive findings that required intervention. The difference in equivalent background radiation is 10 days for a CXR and 2yrs for a CT chest. Please refresh yourselves on the guidance in TEMPO and help us improve. |
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Emergency Trauma Booklets - New distribution system We are introducing a new system to deal with the ED Trauma Booklets' requests. While requests can be submitted continuously, from April onwards we will post out all requested booklets bimonthly, on the first Wednesday. An email reminder will be circulated before each deadline. Please note, since we work remotely, we are unable to deal with urgent queries, therefore please make sure you have adequate stock to ensure the flawless running of the system. Requests can be submitted to trauma.east@nhs.net or directly to Kitti Czegledi (Network Administrator). |
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How to get involved? From injury prevention to rehabilitation, trauma care covers all interests. Get involved with your local Trauma Committee or send us in your ideas. We will be developing more ways for you to get involved with our Specialist Advisory Groups and with your patients through Trauma East Voices. | | |
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