Delays in arrival of critically injured children at Starship

ROYAL AUSTRALASIAN COLLEGE OF SURGEONS

Significant delays in arrival of critically injured children at Starship

Wednesday 8 May, 2013

Auckland is in desperate need of a structured trauma system, delegates to the 82nd Annual Scientific Congress (ASC) of the Royal Australasian College of Surgeons, have been told.

A study conducted by the Paediatric Trauma Service at Starship Children's Hospital (SCH) has highlighted significant delays in severely injured children arriving at the hospital, a centre of definitive care.

Citing Accident Compensation Corporation figures, Dr Clara Chong and Mr James Hamill said New Zealand children are twice as likely to die from injury as those in Australia.

“The absence of a trauma system is contributing to this poor outcome,” the authors said.

“In the setting of severe trauma, the American College of Surgeons advocates direct transport to the centre of definitive care. In Auckland, SCH is the dedicated paediatric trauma centre. The aim of our study was to quantify the delay in reaching the centre of definitive care.

“We analysed the trauma registry of SCH over a five year period (1/9/2006 to 31/8/2011). The criteria for inclusion were an Injury Severity Score greater than 15 and injury sustained in the South Auckland region. We identified 100 severely injured children, all victims of blunt trauma.

“Of these, 88 presented initially to their local hospital requiring secondary transfer to SCH. Transferred children took on average 8 hours from injury to the centre of definitive care, compared with 2 hours 35 minutes for those transported directly to SCH.

“Sixteen per cent of the transferred patients received emergency surgery within 12 hours of arrival at SCH. Retrospective application of field triage guidelines identified 68 per cent of our study’s subjects as critically injured at the first point of contact,” the authors said.

“Our study demonstrated significant delay in reaching the centre of definitive care for severe paediatric trauma. A trauma system needs to be implemented, with triage criteria and hospital by-pass protocol in place. This would expedite care of these children, ensure definitive treatment in a timely manner and, in all likelihood, improve outcomes.”

Approximately 1200 surgeons from New Zealand, Australia and around the world are attending the ASC, which runs from 6 to 10 May and is being held at Auckland’s Skycity/Crowne Plaza Convention Centre.

ENDS

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