> I am interested in list member's experience of Hospital By pass for Major
> Trauma. Does anyone have any experience with protocols within the UK ?
The Leeds Hospitals have operated a selective bypass policy for the last
three years. Neurosurgery and Cardiothoracic surgery are both based at the
General Infirmary, plastics and "complex orthopaedic" are based at St. James'.
Basic principles:
to nearest if
unable to secure airway
CPR in progress
isolated uncomplicated closed limb injury
any abdominal or closed chest injury
burns
head injury (GCS 9 or above)
to LGI
severe isolated head or facial injury
head injury (GCS <9) with any other injury
penetrating chest injury
to SJUH
open, penetrating or multiple limb injury
limb injury with compromise of distal circulation or nerve function
complex hand injury
Getting enough numbers to be able to show a significant difference to outcome
or even timing is proving difficult, but by and large it seems to work quite
well and the subjective impression is that sick trauma transfers across the
city are down in number.
The Yorkshire Air Ambulance does have bypass permission for "severe and life
threatening" trauma direct to the Regional Specialist Centre (for whichever
injury type) but that is a rather specific group and not generally applicable
to a whole Service.
Darren W
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