Training Rural Trauma Care Providers
Maxine Burrell
Outline
Training Rural Trauma Care Providers:
The WA Experience
* Uniqueness of WA
* Tyranny of Time and Distance
* Options and Challenges for Trauma Education
* Some Solutions for WA
NZ
* Population 4.3m
* Median Age 35.6
* Male/Female Ratio:
95.1:100
* Sheep 39m (9:1)
(Statistics NZ, 2009)
WA
* Population 2.2m
* Median Age 36.3
* Male/Female Ratio:
102.9:100
* Sheep 23m (10:1)
(ABS, 2009)
"So where the bloody hell are you?"
* 39.9% of majors (ISS >15) rural
* Median ISS 24
* Average time from trauma to arrival definitive care: 11:6mins (median 9:5mins,
Range 1:55mins - 10:18mins)
* Mode of arrival: Helo 19%; RFDS 74%
* Cause of Trauma: Road 67%; Falls 11%
* 160 St John Ambulance locations operating in country WA
* 2000 volunteer ambulance officers and 70 paid paramedics
* 104 country Sub Centres which are staffed entirely by volunteer ambulance
officers and 12 country Sub Centres with a mix of volunteer and career ambulance
officers.
* Timely Diagnosis
* Control and Correction of Primary Injury
* Prevention of Secondary Injury
* Danne P D. 2003. Trauma Management in Australia and the Tyranny of Distance.
World J, Surg. 27, 385-389.
* Integrated Trauma System
- Disaster Preparedness
- First responders
- Interim care
- Transport
- Definitive care
- Rehabilitation
- Return to the community
* Coordinated
* Resourced
* Consistent
* Assessable
* Accessible
* Medical
* Nursing
* Paramedics
* Allied Health
* Hospital executives & management
* Australian College of Critical Care Nurses
* College for Emergency Medicine
* College of Emergency Nurses Australia
* Rural GP
* St John Ambulance
* Western Australian Country Health Service (Medical and Nursing)
* Initial Assessment
* Airway Management & Ventilation
* Shock
* Thoracic Trauma
* Abdominal Trauma
* Head Trauma
* Spine & Spinal Cord Trauma
* Musculoskeletal Trauma
* Burn & Cold Injury
* Paediatric Trauma
* Trauma in Women
* Transfer to Definitive Care
* Initial assessment
* Shock
* Brain & craniofacial trauma
* Thoracic & neck trauma
* Abdominal Trauma
* Spinal cord & vertebral column trauma
* Demonstration of the trauma process
* Trauma & pregnancy
* Trauma in children
* Trauma in the elderly
* Psychosocial aspects of trauma care
* Stabilisation, transfer and transport
* Burn trauma
* Epidemiology, biomechanics & mechanisms of injury
* Kinematics of Trauma
* Airway Management and Ventilation
* Spinal, Head and Thoracic Trauma
* Patient assessment & Management
* Abdominal Trauma/Trauma in Pregnancy
* Considerations in the Paediatric and Elderly Patient
* Shock and Fluid Resuscitation
* Thermal Trauma Injuries
* Golden Principles of Prehospital Trauma Care
(Queensland Government)
Strategic Thinking and Decision Making Topics:
* Damage Control in Trauma
* Blunt and Penetrating Thoracic Injuries
* Penetrating Injuries to the neck
* Abdominal Injuries
* Pelvic Fractures
* Vascular Injuries
* Head Injuries
Operative Approaches and Surgical Techniques:
* Thoracotomy and Sternotomy
* Laparotomy and Packing
* Fasciotomy
* Craniotomy
* Splenectomy and Splenorrhaphy
* Liver packing
* Medial Visceral Rotation
* Duodenal and Pancreatic Repairs
* Vascular Repairs
* Cardiac and Pulmonary Repairs
* Initial Assessment
* Pain Management
* Head Injury
* Paediatric Trauma
* Abdominal Trauma
* Chest Injury
* Pitfalls of Interhospital Transfer
Inpatient trauma management training that is:
* Deliverable
* Cost effective
* Sustainable
* Meets the need
* Queensland Government. Skills Development Centre. Available:
www.sdc.qld.edu.au/phtls.htm
* Royal Australasian College of Surgeons. Available:
www.surgeons.org/Content/NavigationMenu/EducationalTraining/Skills/EMST
* Sharpe, J. Trauma Coordinator Townsville Hospital, QLD (verbal communication)
* Tippett J. 2004. Nurses' acquisition and retention of knowledge after trauma
training. Accident and Emergency Nursing. 12, 39-46
* Trauma Nursing. 2007. Trauma Nursing Core Course (TNCC). Available:
www.traumanursing.org/tncc_course_info.htm
* Trunkey DO. 1983. Trauma. Scientific American. 249, 2: 176-182
* Western Australian Centre for Remote and Rural Medicine. 2005. Living and
Working in Western Australia. Surviving and Thriving in Rural and Remote Western
Australia. Available: www.ruralhealthwest.com.au
* WAtoday. Available: www.WAtoday.com.au
* Western Australia Trauma Education Committee. 2008. Western Trauma Course
Annual Report 2007/2008. Department of Health, WA
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Ministry of Health
