trauma program annual report[1] · anatomy of injury all penetrating injuries to head, neck, torso,...

Trauma Program Annual Report

Red Deer Regional Hospital‐ Central Zone

April 1 2010‐March 31 2011

Prepared by:

Brenda Wiggins Central Zone Trauma Coordinator

Kyla Hoogers Central Zone Trauma Data Analyst

Dr Lyle Thomas Central Zone Trauma Medical Director

2

Table of Contents:

Introduction ..................................................................................................................................................... Page 3

Medical Director’s Message.............................................................................................................................. Page 4

Mission ............................................................................................................................................................. Page 5

Structure of the Trauma Program ..................................................................................................................... Page 6

How data is collected? ....................................................................................................................................... Page 6

Who qualifies to be in the Registry? .................................................................................................................. Page 7

AIS/ISS explained................................................................................................................................................. Page 7

Trauma Activation............................................................................................................................................... Page 8

Education............................................................................................................................................................ Page 10

Trauma Program Accomplishments.................................................................................................................... Page10

Performance Improvement and Patient Safety.................................................................................................. Page 11

Audit filters.......................................................................................................................................................... Page 11

Future Goals........................................................................................................................................................ Page 12

Stats for the Central Zone................................................................................................................................... Page 13

‐Total # of trauma patients............................................................................................................................... Page 13

‐Direct arrivals vs. private auto......................................................................................................................... Page 14

‐Admitted vs. transferred to Higher Level of Care............................................................................................ Page 15

‐Destinations when transferring to a Higher Level of Care............................................................................... Page 16

‐Pediatric trauma, admitted vs. transferred..................................................................................................... Page 17

‐Types of Injuries............................................................................................................................................... Page 18

‐Gender Breakdown.......................................................................................................................................... Page 19

‐Mechanism of Injury........................................................................................................................................ 0

‐Mechanism of Injury by age............................................................................................................................. Page 21

‐Place of Occurrence......................................................................................................................................... Page 22/23

‐Destination after the Emergency Department................................................................................................ Page 24

‐Sports and Recreation..................................................................................................................................... Page 25

‐Work related Injuries....................................................................................................................................... Page 26

‐Deaths.............................................................................................................................................................. Page 27

3

The Central Zone Trauma Program was established January 2008, formerly the David Thompson Health Region. Funding

was provided by Alberta Health and Wellness to develop a Level 3 Trauma Program at the Red Deer Regional Hospital.

The Trauma Program from the Red Deer Regional Hospital began participating on The Provincial Trauma Committee in

2008 this was the beginning of the Alberta Trauma System.

The Central Zone Trauma Program services approximately 445,004 (AHS, 2010) people over 95 000 square kms, both

urban and rural. It is situated between Edmonton and Calgary along the QE ll highway, covering the south central

portion of the Province of Alberta.

4

Trauma Medical Director’s Message

Having been involved since the inception of the Central Zone Trauma Program, I am truly amazed by the growth that has taken place over the last year. As our infant program grows, so should the pride of those involved in the monumental task of improving trauma care in our region and the entire province. While I am thankful to be able to participate in it’s growth, nothing would be possible without the tireless work of our trauma coordinator, data analyst and the clinicians and allied health workers involved in the everyday care of our trauma patients. I am also thankful for the continuous support we receive from all our partners in both the Northern and Southern Alberta Trauma Systems.

There were several highlights for the Central Zone Trauma program over the past year. Most notably was the accreditation of the Red Deer Regional Hospital (RDRH) as a Level 3 trauma center. Thanks to the support of all physician and nursing staff, administration and our partners in the Southern Alberta Trauma System, we were able to achieve this lofty goal. The exhausting but informative process of accreditation by the Trauma Association of Canada helped open our eyes to recognize the great trauma care already being provided by all health care staff within our region. More importantly though, it identified the many areas where we can continue to grow to further improve trauma care for our patients. The accreditation was not a final destination, but instead a stepping stone to see the new heights we can achieve as a trauma system. The challenge to improve has been met with great enthusiasm by the Trauma Program and we look forward to working towards new goals and ideas.

As we go forward, we remain committed to certain goals that were identified at the outset of our program. Standardizing trauma care across the region is important to ensure equal quality of care to all trauma patients within our system. The creation and dissemination of treatment guidelines, use of standardized trauma assessment sheets, and the newly created EMS destination protocols will help us attain this goal. Education remains a top priority, both onsite at RDRH and at our peripheral hospitals. The success of our First Annual Central Zone Education Day has inspired us to make it an annual event to share knowledge and experiences with all our trauma partners. Quality assurance through chart reviews and analyses of our data collections and QI filters remains the corner stone to maintaining the high standard of trauma care we aspire too.

Many thanks again to all those whose hard work and dedication has improved trauma care in the Central Zone over the past year. We continue to rely on your passion and support to make our next year even more successful.

Dr. Lyle Thomas MD, CCFP(EM)

Medical Director, Central Zone Trauma Program

5

Vision

To provide outstanding trauma care.

Mission

Our mission is to establish and manage a systematic approach to trauma care in the Central Zone. This will be achieved

by using best practices and striving for optimal outcomes, focusing on acute care, rehabilitation, and injury prevention.

We support the Provincial Trauma initiative in getting ‘the injured person to the right treatment at the right facility in

the shortest amount of time.’

6

Structure of the Trauma Program

How data is collected?

Each month a report is run from the meditech system on all the ER patients. Once this is run the Trauma Coordinator

filters out the trauma patients and requests charts to review. The charts are reviewed by the Trauma Coordinator and

further culling of those charts are done if they are an ISS of >9 the Trauma Data Analyst will review and enter them into

the trauma registry. Only the ISS ≥ 12 is submitted to the Alberta Trauma Registry and the National Trauma Registry.

For the year of 2010/2011 339 charts were reviewed and 104 were entered into the Trauma registry.

The Trauma Registry

The trauma registry is a requirement for any accredited trauma center, by the Trauma Association of Canada. The

trauma registry is a data based software that collects fields of information from the trauma chart. This information is

entered by the Trauma Data Analyst. The information entered into the registry is pulled and used for the use of

Performance Improvement and Patient Safety.

Central Zone Trauma Medical Director

Central Zone Trauma Coordinator

Trauma Data Analyst Trauma Secretary

Medical Director of the Emergency Departments in the Central Zone

Emergency Department Manager

Central Zone Trauma Committee

Central Zone Medical Director

Director of Emergency/Critical Care Services Nursing

7

Who qualifies to be in the registry?

Data collection started April 1 2008 with the criteria below. The Trauma Registry at the Red Deer Regional hospital has contributed to the Alberta Trauma Registry and the National Trauma Registry since April 1, 2008. There are graphs following that will reflect comparisons to these previous years.

If any of the following conditions are present and the patient has an ISS (Injury Severity Score) of ≥12 the patient will be

entered into the trauma registry

Admission to the Red Deer Regional Hospital

Transfer to a higher level of Care

Trauma Death in the Emergency Department

Patients that die at the scene are not included in the trauma registry.

How the ISS is is calculated?

AIS Score

AIS is anatomically based and are not contingent on long‐term outcome. It assesses the severity of single injuries. There

is a scale ranking the level of severity:

1=minor

2=moderate

3=serious

4=severe

5=critical

6=maximum (currently untreatable)

Death is not part of the severity scale; therefore, dying doesn’t automatically mean a score of 6

Injury severity score:

ISS (Injury Severity Score) is an anatomical scoring system that provides an overall score for patients with multiple

injuries.

Each injury is assigned an Abbreviated Injury Scale (AIS) and is allocated to one of six body regions (Head, Face, Chest,

Abdomen, Extremities including pelvis, and External)

Only the highest score in each body region is used. The three most severely injured body regions have their score

squared and added together to produce the ISS score.

The range of the ISS is 0‐75. The higher the score the more injured the patient.

8

Example of ISS (Injury Severity Score) calculation:

Region Injury AIS ISS

Head and Neck ‐Frontal lobe contusion 3 9

Face ‐No injury 0

Chest ‐Pneumothorax 3 9

Abdomen ‐No injury

Extremity ‐Fractured radius

‐Fractured femur

‐Fractured pelvis

2

3

2

9

External ‐Laceration to forehead 1

Total ISS 27

Trauma Activation

The following are criteria at the Red Deer Regional Hospital Emergency Department for trauma activation. The triage

nurse receives a telephone report from EMS, transferring hospital or the patient comes by private auto to the

Emergency Department. The nurse then makes the decision to activate the trauma team based on the physical

assessment and the following criteria.

Vital Signs and Level of Consciousness:

Glasgow Coma Scale <14 or

Systolic Blood Pressure <90 or

Respiratory Rate <10 or >29 (<20 in infant < one year) Anatomy of Injury

All penetrating injuries to head, neck, torso, and extremities proximal to elbow and knee

Flail chest

2 or more proximal long‐bone fractures

Crush, degloved or mangled extremity

Amputation proximal to wrist and ankle

Unstable pelvic fracture

Open or depressed skull fracture

Paralysis

9

Mechanism of Injury

Falls ‐Adults: > 20 feet (one story is equal to 10ft)

‐Children: >10 ft. or 2‐3 times the height of the child

High risk auto crash ‐Intrusion: >12 inches occupant site; > 18 inches any site

‐Ejection (partial or complete) from automobile

‐Death in same passenger compartment

Auto vs. pedestrian/bicyclist thrown, run over, or with significant (>20mph) impact

Motorcycle crash >20mph Special Patient or System Considerations (consider these criteria in combination with the above criteria)

Age ‐Older Adults: Risk of injury death increases after age 55

‐Children

Anticoagulation and bleeding disorders

Burns ‐2nd degree and 3rd degree totaling> 20% TBSA

‐Airway/Facial Burns

Time sensitive extremity injuries

End‐stage renal disease requiring dialysis

Pregnancy >20 weeks

Initially the Emergency department physician, 3 nurses, 1 respiratory therapist, lab tech and radiology tech respond to

TTA (Trauma Team Activation). The emergency physician acts as the TTL (Trauma Team Leader). The services of General

Surgery, Orthopedics, Plastics, Pediatrics, Anesthetists, ICU intensivist are available by phone.

Any patient requiring the specialties of neurosurgery, spine surgery, and cardiovascular surgery cannot stay in Red Deer

and must be transferred out. They will be stabilized and a transfer arranged.

10

Education

In 2010‐2011 numerous educational opportunities were made available not only to the staff at the Red Deer Regional

Hospital but the rural hospitals in the Central Zone.

Telehealth‐Opportunities were made available from the Foothills Medical Center Trauma Services Trauma Rounds.

TNCC/ENPC –There were five TNCC courses and 2 ENPC courses offered in the central zone by the education

department. The Trauma Coordinator instructed in 3 TNCC courses for this fiscal year.

Outreach education was made available to rural nurses‐the Trauma Coordinator travelled to Rimbey, Drayton Valley and

Daysland doing Trauma Scenarios. In addition any reviewed any special educational requests and updates on the

trauma system

In house education‐In‐services on Spinal precautions and log rolling with the staff of the ER, ICU, DI and the Respiratory

Therapist was completed. Spinal precautions and log rolling were also reviewed with new staff in the ER orientation.

What did the Trauma Program accomplish in 2010/2011?

Continued participation on the Provincial Trauma Committee

Finalized the draft of the spinal clearance flowchart/spinal precautions policy

Reviewed and accepted the completed version of the Massive Transfusion Protocol developed by the

Transfusion Committee for trauma patients.

Prepared and participated in accreditation of the Southern Trauma System with the Trauma Association of

Canada

Trained a new Trauma Data Analyst and developed an orientation for Trauma Data Analyst at the Red Deer

Regional Hospital.

November 2011 Red Deer Regional Hospital was accredited as a Level 3 Trauma Center by the Trauma

Association of Canada.

11

Performance Improvement and Patient Safety

A retrospective review of all the charts with an ISS of ≥12 and trauma deaths are screened and pulled by the trauma

coordinator and the data analyst. Audit filters/performance indicators assist in flagging charts for review. The Trauma

Medical Director and the Trauma Coordinator do a retrospective review of these charts to identify any issues affecting

the quality of patient care.

If any issues are identified, the processes to resolve the issue are dealt with in the following ways:

The Caregivers are spoken with directly

EMS issues are discussed with the Central Zone EMS director

The Quality Improvement Committee may be contacted about issues that are becoming trends. Processes can

be developed via policy or education to resolve the specific identified issues.

The following audit filters were used in 2010/2011 to flag charts for review:

Audit filters 2010/2011

1. Absence of any pre‐hospital ambulance reports from any phase of patient transport.

2. Absence of q30min chart documentation for patient beginning with ER, including time in radiology, up to admission

to the OR, ICU, ward, death or transfer to another hospital.

2a. Absence of appropriate patient vital signs documentation (BP, P, RR, GCS, and temp.) based on patient’s condition:

‐If patient UNSTABLE vitals<or =q5min

‐If patient is STABLE vitals q15min x4, q30min x2 and q1hr thereafter.

‐If temperature<34, minimum temperature q 30 min

3. Absence of sequential neurological documentation on ER record if patient had a diagnosis of skull fracture,

intracranial injury, or spinal cord injury.

3a. Absence of sequential neurologic documentation (GCS and Pupils)

‐‐If GCS>=14 q1hr x4 then decrease

‐If GCS11‐13 q1hr

‐If GCS <11 at min.q1hr as needed

4. Patient with epidural or acute subdural with transfer delay > 4hrs

5. Patient with diagnosis at discharge of cervical spine injury not indicated in admission diagnosis.

6. Did the unstable patient require a laparotomy that was not performed within 1hr of arrival to the ER?

12

7. Patient sustained a gunshot wound to the abdomen who was managed non operatively. 8. Patient with a femur fracture that was operated on >24hrs after admission.

9. If the patient sustained a compound extremity fracture, was the operation performed >6hrs after admission?

10. Was there an unplanned return to the OR within 48hrs of initial procedure?

11. Trauma patient admitted to hospital under other than a surgeon or intensivist.

12. Patient had missed injuries that subsequently required surgery.

12. Any injury not diagnosed with 24 hrs of entry to RDRH.

13. Was the trauma team called?

13a. Did the team response exceed >10min

14. Length of time at rural hospital was >2hrs?

14a. If <200km from a trauma center, arrive at trauma center within 2.5hrs of initial EMS contact?

14b. If 200‐400km from a trauma center, arrive at a trauma center within 4hrs of initial EMS contact?

14c. If >400km from a trauma center, arrive at a trauma center within 6hrs of initial EMS contact?

15. Patient died during transport.

16. Patient died <24hrs of admission.

Future goals

For the year 2011‐2012 we would like to continue with the education within the Red Deer Regional Hospital

including the Emergency Department, Intensive Care and Unit 23. Provide the staff with practice guidelines

specific to their area of practice.

Increase the number of trips to the rural hospitals to provide trauma education opportunities to both Physicians

and Nursing.

Co‐ hort trauma patients on to a single surgical unit.

Continue working on a relationship with the Central Zone Injury prevention program and become more involved

with injury prevention

Make more Telehealth educational opportunities available to the staff at RDRHC.

Evaluate and make changes to the Performance Improvement and Patient Safety including have Morbidity and

Mortality rounds.

Reevaluate the Trauma Activation guidelines

13

How many Major Trauma Patients were seen at Red Deer Regional Hospital?

The total number of trauma patients seen in the RDRHC emergency department in 2010‐2011 with an ISS of ≥12.

Admitted, transferred or Died in the ER were 104.

The 3 year trend graph shows a 22% increase in trauma patients with and ISS of ≥12 from 2009/2010 to 2010/2011, a

17% increase from 2008/2009 to 2009/2010

There were 1064 Minor and Major trauma admissions, transfers, or deaths to RDRH (regardless of the ISS) for 2010‐

2011

6781

104

0

20

40

60

80

100

120

2008/2009 2009/2010 2010/2011

NU

MBER

OF

PA

TIE

NT

S

YEARS

TOTAL NUMBER OF PATIENTS INJURY SEVERITY SCORE >12

2008 -2011

14

The arrivals by ambulance vs the arrivals by private auto did not significantly change over the past 3 years:

In 2010/2011 78% of arrivals to RDRHC ER arrived by ambulance, 22% arrived by private auto



15

Transfers to higher level of care 2010/2011

57%admitted to RDRHC

43% transferred to higher level of care

Transfers to higher level of care 2009/2010

54% admitted

43% transferred

Transferred to higher level of care 2008/2009

46% admitted

54% transferred

Through the past 2 years the number transferred vs admitted has stayed virtually unchanged. The first year of data

collection there were slightly less major traumas admitted to RDRHC.

31

44

59

36 35

45

0

10

20

30

40

50

60

70

2008/2009 2009/2010 2010/2011

NUMBER

OF PATIEN

TS

YEARS

ADMITTED VS. TRANFERRED TO A HIGHER LEVEL OF CAREISS ≥ 12

2008 TO 2011

ADMITTED TO RDRHC

TRANSFERRED TO HIGHER LEVEL OF CARE

16

ALBERTA CHILDREN'S HOSPITAL 3%

(2)

FOOTHILLS MEDICAL CENTRE 63%

(41)

ROYAL ALEXANDRA HOSPITAL 5%

(3)

STOLLERY CHILDREN'S HOSPITAL 3%

(2)

UNIVERSITY OF ALBERTA HOSPITAL

26%(17)

Destinations When Transferred to a Higher Level of Care

2010/2011

ALBERTA CHILDREN'S HOSPITAL

FOOTHILLS MEDICAL CENTRE

ROYAL ALEXANDRA HOSPITAL

STOLLERY CHILDREN'S HOSPITAL

UNIVERSITY OF ALBERTA HOSPITAL

When transferring to a higher level of care the Red Deer Regional Hospital will to any of the following Trauma Centers;

including University of Alberta Hospitals, Stollery Children’s hospital, Royal Alexandra Hospital, Foothills Medical Center

and the Alberta Children’s hospital.

The decision to go to Edmonton or Calgary is always made on a case to case basis. It is made according to patient wishes

and resources available to best serve the patient’s condition.

It was always thought that 50% went to Edmonton and 50% went to Calgary but for 2010/2011 but for the adult trauma

population 63% went to the Foothills Medical Center and 26% to the University of Alberta/5% to the Royal Alexandra

Hospital.

The Pediatric Trauma patients were evenly split between Stollery and Albert Children’s Hospital at 3%.

17

Pediatric Trauma

The number of major pediatric patients (ISS ≥ 12) seen at Red Deer Regional Hospital has remained constant over the

past 3 years. Many pediatric traumas have been seen and admitted to RDRHC but only 10 pediatric trauma patients

were an ISS≥12.

A total of 5 pediatric trauma patients were transferred out and 4 of those were sent to Stollery and Alberta Children’s,

the 5th patient went to the Foothills Medical Center.

0

1

2

3

4

5

6

7

8

2008/2009

2009/2010

2010/2011

33

54

8

5

PEDIATRIC PATIENTS ADMITTED VS. TRANSFERRED

INJURY SEVERITY SCORE ≥ 122008 TO 2011

ADMITTED

TRANSFERRED

18

BLUNT 90%(94)

PENETRATING 6%(6)

BURNS 3%(3)

OTHER 1%(1)

TYPES OF INJURIES ISS ≥ 12

2010/2011

BLUNT

PENETRATING

BURNS

OTHER

Blunt injuries continue to be the leading cause of injury with 90% of the total major trauma seen at RDRHC. 6% of

patients were penetrating injuries and 3% burns. The ‘other’ category is a hanging.

The Penetrating injuries are much higher in the Red Deer hospital than the numbers show. Many are not seriously

injured and can be discharged home, but the limitations of the AIS/ISS scoring does not capture the majority of admitted

penetrating injuries falling between ISS of 9 and 12.

19

AGES NEWBORN TO 16

AGES 17 TO 34 AGES 35 TO 52 AGES 53 TO 70 AGES 71 AND OLDER

7

2928

87

35

65

6

NU

MB

ER

OF

PA

TIE

NT

SGENDER BREAKDOWN

INJURY SEVERITY SCORE > 122010/2011

MALE

FEMALE

The males between 17 and 52 were the highest number of major traumas seen at the Red Deer Regional Hospital

Overall 68% of major traumas (ISS ≥12) were males and 32% females.

45% of the major trauma was between the age of 17 and 52 and male

20

The three leading mechanisms of injury for major trauma (ISS ≥12) in the Central Zone were; Motor Vehicle Collisions

(38%, n=40), Falls (26%, n=27) and Assaults (11%, n=11)

The ‘Other’ injuries include burns, hangings, chemical injury and drownings.

Most of the falls that qualify are not ground level falls, ground level falls are usually hip fracture and do not qualify for

the Alberta Trauma Registry and the National Trauma Registry (ISS ≥12).

FALLS 26%(27)

MOTOR VEHICLE COLLISIONS 38%

(40)

NON‐MOTOR VEHICLE COLLISIONS 10%

(10)

ASSAULTS 11%(11)

OTHER 15%(16)

MECHANISM OF INJURY ISS ≥ 122010/2011

FALLS

MOTOR VEHICLE COLLISIONS

NON‐MOTOR VEHICLE COLLISIONS

ASSAULTS

OTHER

21

< 15 15 ‐24 25 ‐ 34 35 ‐ 44 45 ‐ 54 55 ‐ 64 65 ‐ 74 75 ‐ 84 85 +

Transportation 4 15 5 6 10 5 3 3 0

Falls 1 2 3 3 5 1 3 7 2

Assaults 0 3 2 3 1 0 0 0 0

Burns 2 0 0 1 0 0 0 0 0

Suicide/Self harm 0 0 1 0 0 0 0 0 0

Other 1 1 4 4 2 0 1 0 0

0

2

4

6

8

10

12

14

16

NUMBER

OF PATIEN

TS

MECHANISM OF INJURY BY AGE RANGEINJURY SEVERITY SCORE > 12

2010/2011

Transportation injuries for the ages of 15‐45 were mostly Motor Vehicle Collisions, there were some Motorcycle crashes

and horse related injuries.

After 65 years, ‘Falls’ dominated the major mechanism of injury with ‘Transportation’ coming in second.

22

21%n = 2232%

n = 4

4%n = 34

5%n = 5

2%n = 2

5%n = 5

5%n = 5

26%n = 27

PLACE OF OCCURRENCE OF TRAUMAINJURY SEVERITY SCORE OF 12 OR HIGHER

2010/2011

HOME

STREET/HIGHWAY

SCHOOL/PUBLIC INSTITUTION/ATHLETIC AREATRADE/SERVICE AREA

INDUSTRIAL/CONSTRUCTION AREAFARM

OTHER

UNKNOWN

23

Place of Occurrence

32% of injuries occurred in the street/highway, 21% occurred in the home. The large number of unknown is due to the

lack of documentation on the walk‐ins.

Of the injuries from the streets the largest numbers (91%) come from Motor Vehicle collisions.

Injuries at home are lead by falls at 50%

24

TRANSFER OUT 40%(42)

SURGICAL WARD ADMISSION 43%

(45)

ICU ADMISSION 3%(3)

OPERATING ROOM 10%

(10)

DIED 2%(2)

OTHER 2%(2)

DESTINATION AFTER EMERGENCY DEPARTMENT VISIT

INJURY SEVERITY SCORE ≥ 122010/2011

TRANSFER OUT

SURGICAL WARD ADMISSION

ICU ADMISSION

OPERATING ROOM

DIED

OTHER

Following resuscitation 40% of the major trauma patients were transferred to a higher level of care.

43% will be admitted to a surgical ward, 10% to the OR, 3% to ICU, 2% died

‘Other’ would include palliative or medical unit.

Pediatric patients were included in these totals.

25

In Central Alberta, the highest number of recreational injuries was related to recreational horse use at 32%. These have

all been recreational injuries if there was a situation that a horse is being used for farm work it is documented in work

related injuries.

At 20 % we have ATV/dirt bike injuries followed closely by snowmobile injuries at 16%.

0

1

2

3

4

5

6

7

8

5

2

8

1

2

1

4

11

NUMBER

OF PATIEN

TS

TRAUMA RESULTING FROM SPORTS OR RECREATION ACTIVITIES

INJURY SEVERITY SCORE > 122010/2011

ATV/DIRTBIKES

BICYCLES

HORSE‐RELATED

ICE HOCKEY

SKATEBOARDING

SKIING

SNOWMOBILING

WATERSPORTS

OTHER

26

FARM 3%(3)

CONSTRUCTION/ INDUSTRIAL 5%

(5)

NON‐WORK RELATED 92%(96)

WORK RELATED INJURIESINJURY SEVERITY SCORE ≥ 12

2010/2011

FARM

CONSTRUCTION/INDUSTRIAL

NON‐WORK RELATED

The Central Zone is a large farming community and a home to many oil industry businesses.

In 2010/2011 there was only 3 % of the total major trauma that were attributed to farming injuries.

The City of Red Deer continued to have an increase in the population for 2010\2011. This in turn means construction

and a large industrial population with the oil industry grew. Construction and industrial injuries totaled 5 % of the major

traumatic injuries seen at the Red Deer Regional Hospital.

27

3

1

3

4

1

2

1

2 2

0

0.5

1

1.5

2

2.5

3

3.5

4

4.5

DIED IN EMERGENCY

DIED < 24 HOURS AFTER ADMISSION

DIED > 24 HOURS AFTER ADMISSION

DEATHS DUE TO TRAUMAINJURY SEVERITY SCORE ≥ 12

2010/2011

2008/2009

2009/2010

2010/2011

3 of the 5 deaths were trauma patients that had CPR/ATLS started at the scene and continued upon arrival to the

Emergency Department.

3/5 deaths mechanism of injury were falls.

2 deaths were palliative, the injuries were severe and the wishes of the patient and the family were to provide comfort

but no intubation.

trauma program annual report[1] · anatomy of injury all penetrating injuries to head, neck, torso,...

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