Huge gulf of trauma care between North and South Islands, doctors say
A shortage of dedicated trauma staff in South Island emergency departments results in higher death and severe injury rates than in the North Island, two Christchurch doctors say.
Common causes of major trauma include car, bike and sporting accidents, falls and violence.
Christchurch Hospital Trauma Committee co-chairs Dr Christopher Wakeman and Dr Dominic Fleischer said South Island trauma services were 10 years behind Auckland, 20 years behind Australia and 40 years behind the United States.
"There appears to be a wide gulf in trauma load, trauma systems, trauma funding and outcomes between the north and the south."
Their comments were published in the New Zealand Medical Journal on Friday in Wakeman and Fleischer's article "A tale of two islands - trauma care in New Zealand" .
The Christchurch doctors were responding to a report by the Major Trauma National Clinical Network 2015-2016 and clinical lead Dr Ian Civil's assertion New Zealand was "on the cusp of of achieving a world-class trauma system".
They said the report did not include South Island data, as none was collected.
Appointing of a trauma coordinator at Christchurch Hospital last year allowed data collection for the first time.
The year of data showed Christchurch Hospital was the busiest trauma centre in New Zealand and had higher mortality rates than North Island hospitals, Wakeman said.
The results were an "eye-opener" and confirmed the hospital received one major trauma patient every day, on average.
He said a dedicated trauma service could potentially improve patient care and mortality rates.
Other benefits included shorter hospital stays, earlier mobility, a faster return to work and less complications for patients.
Services in the North Island included specialist trauma surgeons, clinical nurse coordinators as well as registry data entry and analysis personnel.
High-level care started before the patient even arrived at hospital.
"Medically-staffed helicopter retrieval services are able to transfuse blood prior to hospital arrival," they wrote in the medical journal.
In the South Island there were no dedicated trauma surgeons who provided consistent after-surgery care.
Wakeman works as an on-call trauma surgeon, but his main role at the hospital was as a general colorectal surgeon.
"It's having time in your day to do ward rounds for all the trauma patients spread around the hospital."
Auckland and Waikato Hospitals have trauma wards. Wakeman said this would benefit patients in Christchurch.
Having a trauma coordinator was a good first step towards a specialist trauma unit. The hospital tried to recruit a trauma surgeon over the past year.
More investment was needed to improve the service.
Wakeman said the specialty was relatively new and developing, but evidence dating to the 1970s showed dedicated trauma systems saved lives.
He said funding constraints were behind the lag in South Island services.
"We feel that in the South Island we don't have the funding – we're still 10 or 20 years behind Auckland and Waikato."