Victorian hospitals treat more than 4,000 major trauma patients each year, and this number is steadily increasing each year, with over 70% receiving definitive care at an appropriately designated trauma service. Of these, 40% of patients meet major trauma criteria requiring an intensive care admission, and three-quarters of these patients are mechanically ventilated ⁽²⁾.

The majority of trauma in Victoria is predominantly blunt trauma. Falls, motor vehicle incidents, motorbike incidents, pedestrian impacts and incidents involving pedal cyclists are the most common mechanisms of injury.

In recent years there has been an increase in the number of major trauma patients aged over 65 years. This represents approximately one-third of all major trauma cases. The incidence of falls less than 1 metre is rising in this age group, with head injuries being the most common serious injury sustained in this demographic ⁽²⁾. The annual incidence rate of paediatric major trauma patients (aged younger than 16 years) remains low, at 13 per 100.000 in 2021-2022 ⁽²⁾.

The first hospital attended was a MTS, The Austin Hospital (for spinal care) or a metropolitan neurological service (MNS) for 51% of major trauma patients in 2021-2022. Further, the percentage of major trauma patients receiving definitive care at an MTS, the Austin for spinal, or a MNS was 74.6% in 2021-2022 ⁽²⁾.

Patients who meet major trauma criteria outlined in the Major Trauma Advice and Inter-hospital Transfer Guidelines should be stabilised at the referral health service and discussed with ARV within 60 minutes of arrival to arrange for transfer to a major trauma service. ARV provides clinical advice on the management and stabilisation of major trauma patients and coordinates subsequent retrieval and transfer if required.

“The multidisciplinary trauma team approach to trauma resuscitation and stabilisation is one recommended by several bodies (ACS, 1993; NRTAC, 1993). All hospitals designated to receive trauma patients must have a formal organised response to the initial reception and management of trauma patients. The establishment of a trauma team is crucial to this. Clarifying the roles and responsibilities of each member of the team enables an optimally coordinated approach during resuscitation, when many tasks must be carried out simultaneously. Trauma team members should comprise the most skilled clinicians available to fulfil each roll within the team. Clinicians should, therefore be sourced from throughout the hospital”⁽³⁾.

On occasions paramedics may play an active role in the trauma team within rural or regional facilities where availability of experienced and skilled hospital staff may be limited.