The Organisation of Trauma Services for Rural Australia

Abstract

<jats:p>This review discusses the development of trauma care and the retrieval process in Australia, particularly as it impacts on the rural population. In rural and remote settings, trauma is a major cause of death and disability with the death rate from injuries increasing with progressing remoteness. Time is a critical factor in trauma care and the length of time it takes to reach definitive care has a significant impact on patient outcome. In rural areas people have difficulties accessing medical services within a reasonable time period and the delays associated with the provision of trauma care contribute to an unacceptable level of mortality and morbidity. Since it is impractical to provide sophisticated medical services capable of managing severe trauma in rural areas, referral and retrieval form a vital part of the process of rural trauma care. The focus of this review is the management of severe trauma in rural areas. It will discuss the utilisation of clinical guidelines to improve the process of trauma care and examine if they can be used to reduce the time taken by rural health facilities to seek advice and request retrieval services. The evolution of trauma care in Australia, including the referral and retrieval processes, will be discussed and strategies aimed at improving tertiary hospital referral identified.</jats:p>

Larger Regional and Rural Areas in Victoria, Australia, Experience More Alcohol‐Related Injury Presentations at Emergency Departments

“…It has been proposed previously that such towns might develop uniquely harmful cultures around alcohol consumption aligned with conceptualizations of masculine identity. 33 More research is required to further investigate the driving factors behind the higher rates of alcohol consumption and harms within rural and regional areas.…”

“…For example, people who sustain severe injuries in a rural area may be taken directly to a larger ED in a metropolitan region. However, direct transport to larger ED and trauma services is often unrealistic given the large distances and length of transport time; therefore, patients are likely to be taken to the local ED first . Another important limitation is the use of a state‐level sample.…”

“…However, direct transport to larger ED and trauma services is often unrealistic given the large distances and length of transport time; therefore, patients are likely to be taken to the local ED first. 33 Another important limitation is the use of a state-level sample. Future Australian national research should seek to replicate the current findings by exploring rural and regional versus metropolitan differences, and seasonal coastal changes in alcohol-related harms.…”

Tyranny of distance and rural prehospital care: Is there potential for a national rural responder network?

“…Patients might present to the rural clinician with a wide spectrum of critical conditions, requiring initial stabilisation and transfer to metropolitan tertiary centres for definitive care. Prehospital incidents are common in rural areas, with up to 65% of national road fatalities occurring in rural Australia . A Western Australia study showed that rural locations accounted for one‐third of major trauma cases (injury severity score >15) .…”

“…Prehospital incidents are common in rural areas, with up to 65% of national road fatalities occurring in rural Australia. 4 A Western Australia study showed that rural locations accounted for one-third of major trauma cases (injury severity score >15). 5 Whereas transport injuries predominate, other hazards include agricultural and mining industries, as well as envenomations, wildlife-vehicle collisions and environmental hazards.…”