Regional trauma services 

A regional trauma service (RTS) can provide all aspects of care to patients with minor to moderate trauma, and definitive care to a limited number of major trauma patients in collaboration with the major trauma service (MTS). An RTS provides initial assessment, stabilisation, definitive care and initiate transfer to an MTS when a patient requires services not available at the RTS. An RTS is equivalent to a Level 3 Trauma Service as documented in the The Australasian Trauma Verification Program Manual by the Royal Australasian College of Surgeons1 and as seen in the international literature.

RTS locations

There are currently 10 designated RTS in NSW: Map of NSW trauma services
  • Coffs Harbour Base Hospital
  • Gosford Hospital
  • Lismore Base Hospital
  • Nepean Hospital
  • Orange Health Service
  • Port Macquarie Base Hospital
  • Tamworth Rural Referral Hospital
  • The Tweed Hospital
  • Wagga Wagga Base Hospital
  • Wollongong Hospital

Role of the RTS

As per the The Australasian Trauma Verification Program Manual,1 the major role of an RTS service is the provision of high quality care to medium and minor level trauma, with the capability of stabilising major trauma patients who cannot be transported directly to an MTS. It can provide definitive care to a limited number of major trauma patients, in concert, with the designated MTS for their network.

In general terms, an RTS will be able to provide prompt assessment, resuscitation, emergency surgery, and stabilisation of a small number of seriously injured patients, while arranging for their transfer to the responsible the MTS.

An RTS can provide all aspects of immediate care, including some definitive care for non-major trauma patients according to patient needs and available resources. It will have a consistent general surgical service which also provides most aspects of definitive care to severely injured patients. Its principal function, with respect to major trauma, is to provide initial resuscitation and operative stabilisation, prior to appropriate early transfer of major trauma patients, who have attended because of being outside the catchment area of the MTS.

A RTS will have established transfer agreements with the designated MTS for their trauma network. It will require the 24 hour availability of an on-duty specialist surgeon and anaesthetist, as well as a nurse experienced in the care of trauma and radiology facilities. Helicopters should be able to land safely nearby. There will be a varying capacity amongst the RTS for the provision of emergency surgery. In rural areas the RTS provide a trauma referral service to hospitals within their rural network.

RTS staffing infrastructure

The day-to-day coordination of multidisciplinary activities, services and systems necessary to provide to the highest level of trauma care within the RTS are led by the Trauma Nurse Coordinator with support from the Trauma Director. A recommended minimal level of staffing infrastructure of the RTS can be seen below (adapted from NSW Trauma Services Plan (Dec 2009)).

Role RTS
Regional Trauma Director Part time
Regional Trauma Nurse Coordinator (CNC) Full time
Trauma Registry Manager Part time

See also

References

  1. Royal Australasian College of Surgeons (2009). The Australasian Trauma Verification Program Manual. Melbourne: RACS.

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