Emergent craniotomy in rural and regional settings: recommendations from a tertiary neurosurgery unit: diagnosis and surgical decision-making.

Largely attributed to the tyranny of distance, timely transfer of patients with major traumatic brain injuries (TBI) from rural or regional hospitals to metropolitan trauma centres is not always feasible. This has warranted emergent craniotomies to be undertaken by non-neurosurgeons at their local hospitals with previous acceptable results reported in regional Australia. Our institution endorses this ongoing potentially life-saving practice when necessary and emphasize the need for neurosurgical units to provide ongoing TBI education to peripheral hospitals.

Emergent craniotomy in rural and regional settings - recommendations from a tertiary neurosurgery unit: surgical technique and future prospects.

Kenneth G Jamieson described the emergent craniotomy for traumatic brain injuries (TBI) in the rural and regional setting back in 1965 in his book 'A First Notebook Of Head Injury'. Since then, there has been successful use of the technique in peripheral hospitals prior to the safe transfer of patients to metropolitan trauma centres. Although the procedure can be daunting in inexperienced hands, our institution supports ongoing education to continue implementation of trauma craniotomies by non-neurosurgeons if it means another life is potentially saved.

Challenges to trauma care delivery for Australian and New Zealand trauma clinicians.

Introduction: The availability and implementation of evidence-based care is essential to achieving safe, quality trauma patient outcomes. Little is documented, however, about the challenges trauma clinicians face in their day-to day practice, or their views on the availability of evidence. This paper presents the most significant clinical practice challenges reported by multidisciplinary trauma care professionals in Australia and New Zealand, in particular those that may be resolved with focussed research or enhanced implementation activity.

Inclusion of 'minor' trauma cases provides a better estimate of the total burden of injury: Queensland Trauma Registry provides a unique perspective.

Introduction: Injury is recognised as a frequent cause of preventable mortality and morbidity; however, incidence estimates focusing only on the extent of mortality and major trauma may seriously underestimate the magnitude of the total injury burden. There currently exists a paucity of information regarding minor trauma, and the aim of this study was to increase awareness of the contribution of minor trauma cases to the total burden of injury.

Methods: The demographics, injury details, acute care factors and outcomes of both minor trauma cases and major trauma cases were evaluated using data from the state-wide trauma registry in Queensland, Australia, from 2005 to 2010.

The epidemiology of horse-related injuries for different horse exposures, activities, and age groups in Queensland, Australia.

Background: The dangers associated with horse riding, a popular activity throughout Australia, are well documented; yet, few studies have comprehensively described injuries caused by horses to nonriders. This study aimed to facilitate targeted injury prevention strategies and appropriate trauma management by describing all horse-related injuries, for both riders and nonriders, in Queensland, and identifying those at greatest risk.

Methods: Horse-related injury data from 2005 to 2009 were extracted from the Queensland Trauma Registry.

Traumatic abdominal wall herniation: case series review and discussion.

Background: Traumatic abdominal wall hernia (TAWH) is a rare type of hernia occurring secondary to blunt trauma to the abdomen. Its management remains controversial within the surgical community, mainly due to complexities in diagnosis, appropriate surgical approach and timing of closure.

Method: Cases were identified retrospectively, via interviews with trauma surgeons at a Tertiary Trauma Centre, the Royal Brisbane & Women's Hospital, in Brisbane, Australia.

Standardising trauma monitoring: the development of a minimum dataset for trauma registries in Australia and New Zealand.

Introduction: Trauma registries are central to the implementation of effective trauma systems. However, differences between trauma registry datasets make comparisons between trauma systems difficult. In 2005, the collaborative Australian and New Zealand National Trauma Registry Consortium began a process to develop a bi-national minimum dataset (BMDS) for use in Australasian trauma registries.

Epidemiology of traumatic epidural hematoma in young age.

Background: Epidural hematoma (EDH) is a major traumatic brain injury and a potentially life-threatening condition, with the mortality rate in the young age group varying across studies. The aim of this analysis was to investigate the magnitude of traumatic EDH in young patients aged 0 year to 24 years in Queensland, Australia.

Methods: Study patients presented to the emergency department of 14 public hospitals participating in the Queensland Trauma Registry during 2005 to 2007 and were diagnosed and admitted for treatment of EDH.

Using Trauma Injury Severity Score (TRISS) variables to predict length of hospital stay following trauma in New Zealand.

Aim: To develop and assess the predictive capabilities of a statistical model that relates routinely collected Trauma Injury Severity Score (TRISS) variables to length of hospital stay (LOS) in survivors of traumatic injury.

Method: Retrospective cohort study of adults who sustained a serious traumatic injury, and who survived until discharge from Auckland City, Middlemore, Waikato, or North Shore Hospitals between 2002 and 2006. Cubic-root transformed LOS was analysed using two-level mixed-effects regression models.

Contemporary New Zealand coefficients for the Trauma Injury Severity Score: TRISS(NZ).

Aims: To develop local contemporary coefficients for the Trauma Injury Severity Score in New Zealand, TRISS(NZ), and to evaluate their performance at predicting survival against the original TRISS coefficients.

Methods: Retrospective cohort study of adults who sustained a serious traumatic injury, and who survived until presentation at Auckland City, Middlemore, Waikato, or North Shore Hospitals between 2002 and 2006. Coefficients were estimated using ordinary and multilevel mixed-effects logistic regression models.

Characteristics and outcomes of injury patients in an Aboriginal and Torres Strait Islander population--Queensland Trauma Registry, Australia.

Introduction: There are few published data for the magnitude of injury-related health problems in indigenous people such as Aboriginal and Torres Strait Islanders. The objective of our study was to compare the characteristics and outcomes of injury in the indigenous population to the non-indigenous population, who are living in Queensland, Australia.

Methods: Participants were injured patients who presented to the emergency department for treatment and admitted to 15 public hospitals participating in the Queensland Trauma Registry (QTR) during 2003-2005.

The Queensland Trauma Plan project.

Background: The aim of this paper is to outline the development of 'A Trauma Plan for Queensland'. Injury is one of Australia's National Health Priorities. The full impact of injury, including early death, reduction in quality of life and the social and emotional costs to individuals and the community are immeasurable.

Tackling the burden of injury in Australasia: developing a binational trauma registry.

Existing trauma registries in Australia and New Zealand play an important role in monitoring the management of injured patients. Over the past decade, such monitoring has been translated into changes in clinical processes and practices. Monitoring and changes have been ad hoc, as there are currently no Australasian benchmarks for "optimal" injury management.