trauma&training * towards&a&curriculum*basedapproach&&...uk&major&trauma&network •...
TRANSCRIPT
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Trauma Training-‐ towards a curriculum-‐based approach
Shehan HettiaratchyLead Surgeon and Major Trauma DirectorImperial College Healthcare NHS Trust
London UK
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Next 10 minutes....
• UK Major Trauma System development
• UK Surgical training
• Filling the gap........how to create trauma surgeons
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UK Major Trauma Network
• No Trauma system prior to 2012
• 2011-‐2012 went live
• 50% decrease in trauma mortality
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Major Trauma CentresApril 2012 Adult and Children’s
Major Trauma Centres Addenbrooke’s Hospital Cambridge
Frenchay Hospital Bristol
James Cook University Hospital Middlesborough
John Radcliffe Hospital Oxford
King’s College Hospital London
Leeds General Infirmary
Queen’s Medical Centre Nottingham
Royal London Hospital
Royal Victoria Infirmary Newcastle
St Mary’s Hospital London
St George’s Hospital London
Southampton General Hospital
Adult Major Trauma Centres Derriford Hospital Plymouth
Hull Royal Infirmary
Northern General Hospital Sheffield
Queen Elizabeth Hospital Birmingham
Royal Preston Hospital
Royal Sussex County Hospital Brighton
University Hospital Coventry
University Hospital of North Staffordshire Stoke on Trent
Children’s MTCs Alder Hey Children’s Hospital Liverpool
Birmingham Children’s Hospital
Royal Manchester Children’s Hospital
Sheffield Children’s Hospital
Collaborative
Manchester Collaborative MTCa) Salford Royal NHS Trustb) Manchester Royal Infirmary c) University Hospital South Manchester
Liverpool Collaborative MTCa) Aintree University Hospitalb) Walton Centrec) Royal Liverpool University Hospital
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UK has no trauma surgeons
• Specific surgical specialties training
• Major trauma not a recognised specialty
• No formal training mechanism
• Major trauma system run by "amateurs"
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• There is a need to ensure that surgeons are at the heart of major trauma services
• Description of a “Trauma Surgeon”
• Resuscitative Trauma Surgeon
• Major Trauma Centre Surgeon
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RCS Model for Trauma Surgeons
• Resuscitative Trauma Surgeon
– gen/vasc surgery background
– able to do all life saving surgery
– may not need many of them
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RCS Model for Trauma Surgeons
• Major Trauma Centre Surgeon
– any surgical background
– co-‐ordination of teams to ensure holistic care of major trauma patient
– can do some emergency procedures (resuscitative thoracotomy, surgical airway)
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Imperial Model-‐ St Mary's MTC
• "Code Red" surgeon-‐ resuscitative
• Major Trauma Consultant
• 4 ortho, 2 plastics, 4 gen surg/vasc
• Weekly rota 1:12; normal specialty practice outside that
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Summary
• Pragmatic approach to generate trauma competencies
• Sustainable throughout the surgeon's career
• Matching to current UK surgical training
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Thank you
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We can get best outcomes for our patients
Doctors reattach hand of builder after he sliced it off with circular saw Marcin Sawiki could move his hand just an hour after the operation after doctors reattached it when he sliced it off with a circular saw.