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 2) |
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Specialist Advisory Groups The Trauma Network has started to create SAGs to bring together all those involved in a specialist area of trauma care from across the region to advise, share, learn and develop their area of trauma practice. We have already successfully formed a Radiology Group and are working hard to create General Surgery and Critical Care groups too. Further information and useful documents can be found on our website. If you are interested in joining a group, please contact us, as we encourage everyone to get involved. | | |
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Resuming Peer Reviews As we move out of the pandemic we are restarting the Peer Review element of our quality assurance programme. What is this? For each part of the patient pathway there are quality indicators set nationally by the NHS Clinical Reference Group for Major Trauma. Peer Review asks for units to demonstrate how they are achieving these quality indicators and any plans they might have for improvements. Usually a visit to the unit follows and an opportunity for a peer review panel to explore the quality indicators with all involved. The panel consists of people from the Network team, the commissioning teams and other units (the ‘peer’ element). Experience has shown this is a very effective way of driving quality and engaging everyone with the quality of trauma patient care. Do you know how well you are doing on achieving your quality indicators? Ask your Trauma Lead. |
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Assistance with educational opportunities The Trauma Network has recently facilitated a large group booking for a course that provided a 50% discount on course costs when booking as a group. This was a straightforward process and enabled many clinicians to access an educational opportunity at a much reduced cost. If you are aware of similar opportunities that you feel the Network could assist with, please contact Sian Cross (Network Education Lead) to discuss further. |
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Meet Simon, our Clinical Director Coming from my roots in the north west of England, I have now lived, trained and worked in the East of England for 20yrs. I am incredibly fortunate to be a Consultant in Emergency Medicine and in Pre-hospital Emergency Medicine (PHEM) at Addenbrooke’s Hospital, Cambridge. Both of these roles allow me to undertake my passions of caring for major trauma patients, resuscitation, and system development. |
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My PHEM work is through Magpas Air Ambulance which has been based in Cambridgeshire for 50years. As part of the Magpas team (and its Medical Director), I care for patients at the scene of their injury bringing care to the patient often associated with hospital level care. In the ED at the Major Trauma Centre I care for these patients as part of a trauma team, and its great to be part of their continuing care. |
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As Clinical Director for the Trauma Network my aim is to support all elements of the trauma system in providing the best care for patients and improving their outcomes. I work as part of a small committed team who you are being introduced to in these newsletters. Together we want to support you in providing excellent care, support the patients and loved ones in optimising their experience, and support everyone to collaborate as a ….network. |
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Unexpected outcome The TARN database is used to collect and analyse trauma patient outcomes. It will calculate the Injury Severity Score (ISS) for each patient and use this with the patient’s age, initial GCS and co-morbidities to calculate a probability of survival from those injuries at 30 days (Ps). If the patient was very likely to survive but sadly died OR they were very likely to die but actually lived, these are ‘unexpected outcomes’. They are defined as either a Ps over 75% but died OR a Ps of <25% but survived. All Trauma Committees regularly review the unexpected outcomes to look for learning, and these are shared at Network meetings to look for themes that we can address together. There is a suggested template on our website. | | |
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Learning from care - the unexpected survivor Injuries - facial fractures, multiple rib fractures, bilateral pneumothoraces, pelvic fracture, extensive left lower limb fractures and amputation Injury Severity Score (ISS) - 57 (maximum 75) Probability of survival (Ps) - 10.5% UNEXPECTED SURVIVOR An adult male was hit by a high-speed train and was attended by land and air ambulance crews. The patient quickly deteriorated into cardiac arrest and they followed TEMPO guidance to resuscitate, regaining cardiac output on scene after intubating, performing open thoracostomies, applying tourniquets, and giving TXA before transferring to the local Trauma Unit with a short pre-alert. In the ED, the trauma team activated the massive blood loss protocol (transfusing 8 units of blood, 4 of FFP and 1 platelet pool), gained CT scans and contacted the NCS Consultant for support. He was transferred to the MTC with ongoing resuscitation where he underwent multiple surgical procedures and a prolonged stay in the Trauma Intensive Care Unit supported by the rehab and therapy teams throughout. |
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So what can we learn from this ‘unexpected survivor’? - Every drop counts! The attention to haemorrhage control using Celox, tourniquets and dressings was excellent, re-assessed regularly and constantly improved - TXA - appropriate early administration of the bolus and infusion. - Resuscitation through CT i.e. ongoing blood product resuscitation at the same time as going through an early trauma CT. - Use of the Network pathway - this patient was too unstable for a long transfer to the MTC and appropriately was taken to the much nearer TU where rapid resuscitation was started. The liaison with NCS allowed input of all the necessary specialties early on to provide advice quickly and then support transfer. - The patient had no large intracranial injury fortunately which helped their prognosis. What did the TU do after this case? 1. Overhauled their major haemorrhage protocol (got the 20 mins wait for blood down to 7 mins when they have simulated it since) 2. Developed a new process for direct access to CT scanning in trauma, further reducing the time to CT There is learning in every case we attend. Can you learn from this case? |
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Trauma East Voices – Patients at the heart of what we do On 9th February 2021, the Trauma Network hosted the second meeting of its patient and public engagement group, known as Trauma East Voices. Following its initial launch in Oct 2019, it had been paused due to the pandemic, but we are excited to be able to move forwards now, meeting virtually. The purpose of the group is to bring together patients, families, loved ones, clinical staff and service managers from across the Trauma Network to listen to each other’s experiences. Our aim is to use this and other patient feedback to improve the pathway and care provided, and to learn from good examples. |
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Group membership is open to anyone who has been involved in a major trauma and treated within our trauma system in the east of England. This includes patients, loved ones, carers, and those who are still on their journey. We also have representatives from some of the patient focussed organisations and charities who work with trauma patients in the region. Although the Network will assist in facilitating the group, the intention is that it will eventually be run by the group themselves with an elected Chair, and that they will decide what issues are important to them and how they propose to address them. |
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What it is not! The group is not intended to be a support or therapy group. Although we appreciate that talking about experiences may be difficult, anyone requiring further support will be signposted appropriately. It is not a forum for resolving complaints; the NHS provider is expected to deal with these directly. The Network has produced leaflets and posters providing information about the group. These will be distributed to the MTC, Trauma Units, rehabilitation settings and specialist nursing homes. The leaflet can also be accessed and downloaded from our website. The next meeting will be held on 7th September 2021 14:00 - 16:00 For more information, please visit our website or contact us at trauma.east@nhs.net |
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Bye-bye Basecamp We would like to let you know, that we retired Basecamp, our old project space, on 31st May 2021. We continuously use our website to keep you up to date, as well as share all the important information and useful documents. If you were a Basecamp user on any of our project(s) please from now on, refer to our website as the primary source: www.eoetraumanetwork.nhs.uk If you have any concerns or queries regarding to the above, please don't hesitate to get in touch with us via our website, or email us at trauma.east@nhs.net |
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TARN Co-ordinators event With support from TARN, the Trauma Network runs a TARN Co-ordinator event quarterly. The aim of the meetings are to bring together all TARN Co-ordinators accross the region to provide them with the latest TARN updates, as well as creating a safe place for them to discuss and raise any queries or issues. Our next meeting is scheduled for 13th July 2021 9:30 - 12:00 If you would like to join to our group, or request more information please email us at trauma.east@nhs.net or contact directly Kitti Czegledi (Network Administrator). |
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Our brand new logos have arrived! In case you haven't heard the exciting news yet - our brand new logos are finally here! Check them out on our website where you can also read about why we decided to change them and why we chose these. | | |
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Dates for your diary As life slowly starts to return to normal, we are planning to resume some of our training courses and group meetings. Have a look at our new calendar for future dates, that might be of your interest. We are continuously adding new events, so please keep an eye on them. Additional information on courses can be accessed on the 'Training/Courses' page. Should you have an specific interest in a course or meeting or would like to join any of them, please don't hesitate to contact us at trauma.east@nhs.net | | |
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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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