1. Rehabilitation & Trauma Co-ordinator Workshop
Background & Data

2. Why are we here? New major trauma networks started in 2012
Designed to ensure most severely injured got to the right place, right time
Purpose was to save an additional 600 lives per year in England
……..60 of those would be from the Midlands region
Networks were designed on a hub and spoke model

3. Why are we here?

4. Why are we here? TU
MTC

5. RSUH

6. Each year there are 18,517,381 visits to A&E in England
Our N3tw0rk 1n Num8er5
Each year there are 18,517,381 visits to A&E in England
Bangor
27,000
Glan Clwyd
47,000
Wrexham
30,000
Mid Cheshire
77,323
Shrewsbury & Telford
106,702
Burton
127,757
Mid Staffs
46,959
Royal Stoke University Hospital
119,709
Worcestershire Acute Hospitals
141,594
Wye Valley NHS Trust
53,453
Heart Of England NHS Foundation Trust
237,701
Sandwell And West Birmingham Hospitals
176,496
Russells Hall
95,375
Wolverhampton
144,365
University Hospitals Birmingham
97,298
Walsall Healthcare NHS Trust
95,236
George Elliot
64,172
Warwick
63,543
University Hospitals Coventry And Warwick
176,485
Kettering
72,416
Northampton
107,914
Birmingham Children's Hospital
50,297
Our 3 networks account for 2,158,795 of these visits to A&E
Thankfully, we’re not talking about all these patients today !!

7. Who are we talking about?
Patients included decided on by the Trauma Audit & Research Network (TARN)

8. Who are we talking about?
Patients included decided on by the Trauma Audit & Research Network (TARN)

9. Who are we talking about?
Patients included decided on by the Trauma Audit & Research Network (TARN)

10. Who are we talking about?
Patients included decided on by the Trauma Audit & Research Network (TARN)

11. Our N3tw0rk 1n Num8er5
Our 3 networks account for 2 million A&E attendances
Only 8,934 of these will eligible for submission to TARN
(less than 0.5% of A&E activity)

12. Our N3tw0rk 1n Num8er5
2,542
RSUH
4,386
1,850

13. Our N3tw0rk 1n Num8er5
North West Midlands & North Wales
Royal Stoke University Hospital
1083
Royal Shrewsbury Hospital
401
Leighton Hospital
307
Ysbyty Gwynedd District General
278
Glan Clwyd
241
Wrexham Maelor Hospital
232

14. Our N3tw0rk 1n Num8er5
Birmingham, Black Country Hereford & Worcester
Queen Elizabeth Hospital
1274
Birmingham Heartlands Hospital
543
Russells Hall Hospital
457
Worcestershire Royal Hospital
424
New Cross Hospital
368
Sandwell General Hospital
328
Manor Hospital
296
Hereford County Hospital
281
Alexandra Hospital
265
City Hospital Birmingham
150

15. Our N3tw0rk 1n Num8er5
Central England
University Hospital of Coventry & Warwick
1176
Northampton General Hospital
376
Kettering General Hospital
298

16. The TARN process
Each Trust has a local TARN clerk that sends the patient data off

17. The TARN process

18. The TARN process

19. AIS – Abbreviated Injury Scale
An anatomical scoring system that provides a reasonably accurate way of ranking the severity of injury:
AIS
Injury 1
Minor 2
Moderate 3
Serious 4
Severe 5
Critical 6
Unsurvivable

20. ISS – Injury Severity Score
The body is divided into six regions: Head & Neck
Face
Chest
Abdomen
Extremities
External
An AIS score is given to every injury within these 6 regions.
The highest AIS score in each body region is isolated,
The highest 3 of those are squared, and added together to arrive at the ISS

22. 16 4 9 29

23. The Injury Severity Score is very important, and is the real reason we’re actually here today…
…anyone with a score of 9 or greater, should have a rehabilitation prescription completed

24. “If the ISS is calculated after discharge, how do we know who will have a score ≥ 9 ??”

28. What has been the reality ??
Only 40% of patients at TU’s are being submitted to TARN
% of RP’s being completed at TU’s….

30. What should have been the case ??
77% have an ISS 9+

31. Who should we be aware of ??

32. Who should we be aware of ??

33. Who should we be aware of ??

34. Who should we be aware of ??

35. Who should we be aware of ??

37. Questions ???