Section of Epidemiology and Biostatistics, School of Population Health, Faculty of Medical and Health Sciences, Waipapa Taumata Rau | The University of Auckland, Auckland, New Zealand.
Hato Hone St John, Mt Wellington, Auckland, New Zealand; Department of Paramedicine, School of Clinical Sciences, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand.
N Z Med J. 2024 Sep 27;137(1603):89-128. doi: 10.26635/6965.6594.
To evaluate adherence to the New Zealand Major Trauma Destination Policy (MTDP). This audit assessed if, based on their injuries, Emergency Medical Services (EMS) attended major trauma cases were taken to the MTDP determined appropriate hospital. Findings will guide and further improve pre-hospital trauma care and associated patient outcomes.
A retrospective evaluation of adherence to the New Zealand MTDP for a random sample of 100 cases (ISS >12) injured between 31 November 2017-30 November 2018 who survived to hospital. The EMS electronic patient record (ePRF) was reviewed for each case. Adherence was indicated by the transport of injured patients from the scene to the appropriate initial destination based on meeting the respective regional MTDPs.
Overall, there was a 94% adherence rate to the MTDP. For patients that were not classified as requiring transport to an advanced-level trauma centre, there was a 98.9% (n=86/87) adherence compared to 61.5% (n=8/13) adherence in those that did require transport to an advanced-level trauma centre.
There was high adherence to the MTDP, with 94% of cases being taken to the appropriate destination directly from the incident scene. There is scope for improvement in cases whereby the nearest hospital should be bypassed in favour of a more distant advanced-level trauma centre.
评估新西兰重大创伤转运政策（MTDP）的依从性。本次审计评估了根据伤害情况，紧急医疗服务（EMS）是否将重伤患者送往 MTDP 确定的适当医院。调查结果将指导和进一步改善院前创伤护理和相关患者结局。
对 2017 年 11 月 31 日至 2018 年 11 月 30 日期间存活至医院的 100 例（ISS＞12）随机抽样病例的新西兰 MTDP 依从性进行回顾性评估。对每个病例的 EMS 电子病历（ePRF）进行了回顾。如果根据各自的区域 MTDP 将受伤患者从现场转运至适当的初始目的地，则表示符合 MTDP 要求。
总体而言，MTDP 的依从率为 94%。对于未被归类为需要转运至高级创伤中心的患者，有 98.9%（n=86/87）符合要求，而需要转运至高级创伤中心的患者中，只有 61.5%（n=8/13）符合要求。
MTDP 的依从性很高，94%的病例直接从事故现场被送往适当的目的地。在某些情况下，应绕过最近的医院，选择更远的高级创伤中心，这方面仍有改进的空间。
