Learning objectives
To study the standards for trauma radiology national guidelines
To improve the standards in severely injured patients at a level 2 trauma centre district general hospital by comparing the current local practice with national guidelines
Review some injuries identified in our centre during the audit period
To implement improvement measures to align the current practice with best practice and complete the audit cycle by re-auditing following implementation of improvement measures
Background
Severely Injured Patients
Severely injured patients (SIPs) are defined as having an Injury Severity Score (ISS) of >15
The ISS is calculated by assigning an Abbreviated Injury Scale (AIS) of 1-6 to 9 body areas
SIPs should be transferred to a Major Trauma Centre (MTC) unless they are more than 45 minutes from the nearest centre; require stabilisation or are trapped for extended periods
If the above circumstances apply, SIPs will attend a Trauma Unit (such as our centre) and may be subsequently transferred to...
Findings and procedure details
Method
Retrospective audit
Single centre
All whole body MDCT performed during the period 19/07/2019 - 18/09/2019 - two months
Hospital central radiology information system (CRIS) searched by three auditors
N = 73
Five audit standards
"Significant injuries" were identified within the written reports according to the injury severity criteria from the hospital trauma radiology guidelines:
Intracranial haemorrhage
Fracture of the pelvis (not a fracture of the neck of the femur)
Multiple injuries, especially where the risk of haemodynamic instability is a consideration
Results
The results...
Conclusion
We have created two shortcodes derived from the RCR guidelines. We aim to embed the polytrauma request within the electronic requesting system.
We will re-audit following a period of adjustment, hopefully with demonstrable improvement.
Personal information and conflict of interest
J. Weaver; Stevenage/UK - nothing to disclose W. P. Topping; Stevenage/UK - nothing to disclose J. Chui; London/UK - nothing to disclose J. Su; London/UK - nothing to disclose
References
The Royal College of Radiologists (2015) Standards of practice and guidance for trauma radiology in severely injured patients, Second edition
East & North Herts NHS Trust (2019) Trust-wide Procedure for Trauma Imaging in Severely Injured Patients
Jurewicz et al. Exploration of vehicle impact speed - injury severity relationships for application in safer road design. Transportation Research Procedia. 2016 (4247-4256)
TARN (The Trauma Audit and Research Network). The Injury Severity Score (ISS). [online]https://www.tarn.ac.uk/Content.aspx?c=3117