Key Messages

The ongoing coordination of the Victorian State Trauma System (VSTS) is co-funded by the Department of Health and the Transport Accident Commission to ensure major trauma patients are managed in the best possible way.

The objective of the VSTS is to reduce preventable death and permanent disability and improve patient outcomes by matching the needs of injured patients to an appropriate level of treatment in a safe and timely manner.

The VSTS aims to ensure that as many major trauma patients as possible receive their definitive care at a major trauma service (MTS) or equivalent specialist trauma service (the Austin Hospital for spinal cord trauma and the Metropolitan Neurological services for older patients with isolated head injuries). Non-major trauma patients, once identified, should remain in a local facility where their care can best be managed inclusive of family and local support services.

There is clear evidence that the VSTS has been highly effective in improving the clinical management and outcomes of major trauma patients.

Key elements of the VSTS that underpin its success include:

  • coordination of pre-hospital and acute care services
  • designation of two adult and one paediatric hospital as MTS hospitals, with all other potential trauma-receiving hospitals assigned a trauma designation
  • defined triage guidelines for transporting patients to MTS hospitals
  • statewide system of major trauma response through Adult Retrieval Victoria (ARV) and Paediatric Infant Perinatal Emergency Retrieval (PIPER)
  • a ministerial committee and subcommittee to oversee the trauma system

Emphasis points

  • An integrated and inclusive trauma system, the VSTS commenced in 2000.
  • The VSTS delivers a systemic clinical pathway for efficiently managing major trauma patients.
  • The treatment of critically ill patients with multiple injuries requires a multidisciplinary, coordinated and integrated system of trauma care.
  • Integrated trauma care systems have been shown to reduce preventable deaths.
  • The introduction of the VSTS has been associated with a significant reduction in mortality and morbidity from major trauma.
  • The designation of all 140 potential trauma-receiving hospitals reflects the clinical capabilities of each hospital.
  • Compliance with major trauma guidelines and protocols ensures the right patient to the right level of care in the shortest time.
  • Evidence based on data from the Victorian State Trauma Registry indicates overall major trauma patient functional outcomes have significantly improved under the VSTS. Over 85% of  major trauma patients  now receive definitive care at an MTS hospital  or a  specialist trauma service (the Austin Hospital for spinal cord trauma  and the Metropolitan Neurological Services for older patients with isolated head injuries).
  • The first point of call to initiate retrieval and transfer of adult trauma patients is ARV and PIPER for paediatrics.
  • The VSTS will continue to be enhanced and strengthened by the introduction of a statewide trauma education system.

The success of the VSTS and its impact on patient outcomes is a result of the work of all staff providing care to major trauma patients at all stages of the patient journey.

Good early trauma care, appropriate and timely transfer and best practice in definitive care continue to improve outcomes for Victorian victims of major trauma.

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