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Table 2 Essential characteristics of hospitals delivering trauma care in the Regional Trauma Network (RTN) era

From: Trauma networks: present and future challenges

Characteristic Types of Institutions offering care to injured patients
  Major trauma centre (MTC) Trauma unit (TU)
Total no. for England 12-16 80-100
Administration/governance:
Commitment from executive team administration and senior clinical staff to deliver such services 100% 100%
Clinical director for trauma, programme manager and data manager 100% 100%
Full dataset submission to TARN 100% 100%
Commitment to RTN, trauma governance, continuous improvement 100% 100%
Critically injured patients (complex or major trauma) >250 per year Only for few cases when the bypass protocols are not followed (patient in extremis, accident in the premises of TU)
Accident and emergency (A&E): early resuscitation:
A&E availability 24/7 24/7
Resuscitation trauma team leader Consultant 24/7 resident Experienced middle grade 24/7 resident; consultant on calla
Fully staffed with specialist nursing and allied health professionals 24/7 24/7
Band 7 nurse: specialist ED trauma nursing 24/7 Variable
Activation protocols: established prealert pathways 24/7 24/7
Trauma service:
Ongoing patient care post initial resuscitation Consultant on calla Consultant on calla
Admission under a named consultant Consultant on calla Consultant on calla
Consultant-led service for ongoing coordination of the care of major trauma patients Consultant on calla Consultant on calla
Trauma nurse coordinator Yes Variable
Radiology: (X-ray/FAST-CT) Reporting within 24 h Reporting within 24 h
Available high specification CT scanner 24/7 24/7a
Staffed laboratory services 24/7 24/7
Blood bank 24/7 24/7
Massive transfusion protocol 24/7 24/7
Trauma and orthopaedic Middle grade resident, consultant on calla, pelvic reconstruction service, complex limb reconstruction service Middle grade resident, consultant on calla
General surgery Middle grade resident, consultant on calla Middle grade resident, consultant on calla
Neurosurgery Middle grade resident, consultant on calla Variable
Spinal surgery Middle grade on calla, consultant on calla Variable
Vascular surgery Middle grade resident, consultant on calla Middle grade resident, consultant on calla
Anaesthetist Middle grade resident, consultant on calla; ODP support within resuscitation Middle grade resident, consultant on calla
Plastic surgery Middle grade on calla, consultant on calla Variable
Urology Middle grade on calla, consultant on calla Variable
Cardio/thoracic surgery Middle grade on calla, consultant on calla Variable
Maxillofacial/head and neck Middle grade on calla, consultant on calla Variable
Interventional radiology Angio suite available 24/7a, consultant on calla Variable
Dedicated trauma theatres, operating lists Immediately available, ability for second if overwhelmed Immediately available, ability for second if overwhelmed
Intensive care facilities 24/7 24/7
Critical care Middle grade resident, consultant on calla Middle grade resident, consultant on calla
Miscellaneous:
Education-prevention-research programmes 100% Variable
Clinical governance programmes 100% 100%
Interhospital transfer protocols 100% 100%
Trauma rehabilitation programmes 100% 100%
  1. aAvailable in 30 min.
  2. CT = computed tomography; ODP = operating department practitioner.