Major trauma services

A major trauma service (MTS) provides the full spectrum of care for the most critically-injured patients, from initial resuscitation through to rehabilitation and discharge. ⁶

These hospitals provide a range of specialist services. They are delineated as level 6).⁷ An MTS is equivalent to a Level 1 trauma service, as documented in the Australian and Aotearoa New Zealand Trauma Verification Program: Model Resource Criteria For Trauma Services by the Royal Australasian College of Surgeons. ⁶

Locations

There are seven adult and three paediatric MTS hospitals in NSW.

Canberra Hospital is also formally recognised as an MTS provider within the NSW trauma networks. It provides a trauma tertiary referral role to the Southern NSW Local Health District.⁷

See service locations

Role of the MTS

An MTS provides the full spectrum of care for the most critically injured patient, from initial reception and resuscitation through to discharge and rehabilitation. In addition, the MTS provides:

• research
• education and fellowship training
• trauma systems overview
• quality improvement program
• data collection
• prevention and outreach programs
• trauma audit
• leadership responsibilities.

An MTS has a significant trauma case volume to develop and sustain clinician experience and expertise. There is:

• a 24-hour trauma reception team
• prompt 24-hour availability of senior consultant-level general surgeon
• an appointed trauma director
• ideally, a surgical trauma-admitting service (bed card).

Elective and emergency surgery in neurosurgery, cardiothoracic, orthopaedics and plastics are essential for an Adult MTS.

An MTS has first class facilities, including an emergency department, operating theatre suite, and intensive care units. A dedicated emergency operating room is available 24 hours for trauma.

An MTS is the central hub of an integrated system. It is responsible for coordinating both urban and rural trauma services, in any given region and for advising those services. Transfer agreements for reception of patients from other trauma services should be in place. A helipad landing site is essential as well as road and ambulance reception.

An MTS takes a lead role in the coordination and management of mass casualty and disaster preparedness scenarios.

An MTS acts as the principal hospital for reception of inter-hospital transfer of major trauma patients.

Staffing

The day-to-day coordination of multidisciplinary activities, services and systems necessary to provide the highest level of trauma care within the MTS are led by the trauma director and the trauma nurse coordinator.

Review the roles and responsibilities for trauma service staff

The model of care has more details on staffing and resources.