Inclusion Criteria The Trauma Audit & Research Network (TARN)

Trauma patients: Irrespective of age The decision to include a patient should be based on the following 3 criteria being met: Trauma patients: Irrespective of age Who fulfil one of the following length of stay criteria: In hospital for >3 days Admitted to a Critical care area (regardless of LOS) Transferred out for specialist care or repatriation* (total LOS >3days) Transferred in for specialist care or repatriation* (total LOS >3days) Deaths (including deaths in ED, even if COD is medical) *Patients admitted under care of Rehabilitation team only: Not included in TARN AND whose isolated injuries meet one of the following criteria>>>

Exclude (in isolation) HEAD Injuries Include Exclude (in isolation) Skull fracture Scalp injuries Traumatic haemorrhage Spontaneous haemorrhage (stroke, aneurysm ) Brain Contusion Loss of consciousness Brain Laceration/penetration Traumatic Brain swelling Vascular injury Nerve injury Diffuse Axonal Injury (DAI)

Exclude (in isolation) FACIAL Injuries Include Exclude (in isolation) Unstable fracture (usually fixed in theatre) Skin injuries Orbital Blow out fracture Closed/stable fracture/s (even if multiple) Le fort fracture (I, II or III) All other injuries to eye Pan-facial fracture All injuries to ear Vascular injury Nerve injury Eye Avulsion Traumatic Retinal detachment Globe rupture

Exclude (in isolation) NECK Injuries Include Exclude (in isolation) Vascular injury Skin injuries Organ injury Nerve injury Hyoid fracture

Exclude (in isolation) THORACIC Injuries Include Exclude (in isolation) Vascular injury Skin injuries Organ injury Rib fracture/s Flail chest (unstable chest wall) Haemothorax (blood in thorax) Pneumothorax (air in thorax) Haemomediastinum (blood in mediastinum) Pneumomediastinum (air in mediastinum) Sternum fracture

Exclude (in isolation) ABDOMINAL Injuries Include Exclude (in isolation) Vascular injury Skin injuries Organ injury (contusion, laceration, transection, avulsion, perforation, rupture) Retroperitoneal haemorrhage

Exclude (in isolation) SPINAL Injuries Include Exclude (in isolation) Vertebral fracture Spinal strain (whiplash) Vertebral dislocation Ligament Disc injury Nerve root injury Cord injury

Hip fractures Aged <65yrs old Hip fractures aged >65yrs old FEMORAL Injuries Include Exclude >65 years old Hip fractures Aged <65yrs old Neck of Femur, Intertrochanteric, Pertrochanteric or Greater trochanteric Hip fractures aged >65yrs old Distal or Shaft or Subtrochantic #: Any age Femoral Vessel injury Femoral Nerve injury

PELVIS/ACETABULUM Fractures Include Exclude >65 years old Acetabulum fracture Single pubic rami fracture Ischium, Sacrum, Coccyx or Ileum Single pubic rami fracture <65 Multiple pubic rami fractures Symphysis pubis joint injury Sacro-iliac joint injury (SIJ) Lateral compression fracture (LC1-LC3) Anterior posterior compression fracture (AP1-AP3) Open Book fracture Vertical Shear fracture Malgaigne fracture

Exclude (even if multiple) UPPER LIMB or LOWER LEG Injuries Excluding hands & feet Include Exclude (even if multiple) Open fracture Closed fractures &/or dislocations of 1 limb (even if multiple) Total Crush injury All other Nerve injuries Traumatic Amputation Muscle injury Fractures &/or dislocations of multiple limbs Tendon injury Transected vessels Ligament injury Sciatic Nerve injury Sprain

Exclude (even if multiple) HANDS & FEET Injuries Include Exclude (even if multiple) Crush of entire Hand (including carpals, metacarpals and phalanges) Hand or Foot fracture/s Crush of entire Foot (including tarsals, metatarsals and phalanges) Crush: Digits alone Amputation: entire Hand or entire Foot Amputation: Digits alone All other digit injuries Crush = Total destruction of bones, vessels/nerves & soft tissue

Exclude (in isolation) BURN or INHALATION Include Exclude (in isolation) Full thickness burn <10% superficial or partial thickness burn >10% TBS burn Inhalation injury

Exclude (in isolation) OTHER INJURIES Include Exclude (in isolation) Electrocution injuries Bruises Full thickness Frostbite Abrasions Asphyxia (hanging or strangulation) Minor Skin lacerations Drowning Minor Penetrating Injuries to skin Skin lacerations: Blood loss >20% Hypothermia Penetrating injuries to skin: Blood loss >20% Once one injury is TARN eligible. All injuries must be documented in the submission.

Inclusion Criteria: Quiz 1. Should you include? 50 year old Fell Injuries: Closed fractured tibia & fibula on left Died after 2 days Answer: No Injuries must meet criteria, regardless of outcome 2. Should you include? 67 year old Tripped In hospital for 4 days Injuries: Right # Neck of Femur & Right Radius # Answer: Yes 65+ Neck of Femur # with any other (non Hand or Foot) fracture is included. 3. Should you include? 68 year old RTA Fractured Pelvis & Femur Treated in MTC then admitted to local Trauma Unit for rehabilitation only . Answer: Yes (if MTC) as patient received acute care. No: If Trauma Unit Patients admitted for rehab only are not included in TARN.

Inclusion Criteria: Quiz 4. Should you include? 70 year old Frequently faller over past weeks : No definite date of fall. Collapsed with possible stroke or traumatic Subarachnoid haemorrhage Answer: No: Only include if definitely Traumatic, with Date & mechanism of trauma. Any ambiguity as to Traumatic or Spontaneous - exclude 5. Should you include? 45 year old admitted to hospital on 20th February 2015 with medical condition. Fell on Ward on 1st March 2015 & sustained Fracture to skull Discharged on 10th March 2015 Answer: Yes as injury is TARN eligible Date of Arrival & Date of incident should be the date the Trauma occurred in hospital (1st March), not the original medical admission date.

Questions?