Trauma Care in the Tropics
Researchers conducting a major study of trauma care say Australians living in rural and remote regions have shorter lives, higher injury hospitalisation rates, higher mortality rates, and higher healthcare costs than people living in major cities.
Professor Geoffrey Dobson and Dr Hayley Letson from James Cook University’s College of Medicine and Dentistry, along with Dr Clinton Gibbs from Retrieval Services Queensland (RSQ), the Royal Flying Doctor Service (RFDS) and LifeFlight Retrieval Medicine (LRM) are conducting a study aiming to bridge the gaps in trauma care in rural and remote northern Queensland.
“A remarkable fact is that 95 years after John Flynn conducted his first experiment that led to the formation of the Royal Flying Doctor Service (RFDS), there is still little or no systematic knowledge of the type and severity of injuries experienced in the tropics,” said Professor Dobson.
Professor Dobson said the new study has received two years funding from Queensland’s Emergency Medicine Foundation with additional funding support from the Townsville Hospital and Health Service.
“It’s a first-of-its-kind study to classify and characterise trauma patients from North Queensland serviced by Townsville, Cairns, Thursday Island, Mt Isa, and Mackay hospitals over a 3-year period from 2016 to 2018, and covers an area nearly the size of NSW and Victoria combined,” said Professor Dobson.
The first dataset includes around 2300 anonymised patient records that have been retrieved by JCU’s Dr Hayley Letson.
“This is very important information, because it can inform local, state and federal government stakeholders on the current incidence and severity of traumatic injury in the tropics, and any potential gaps in healthcare delivery,” said Dr Letson.
She said about a third of the records relate to Aboriginal and Torres Strait Islander people and early indications show an inordinately large number of head injuries.
The team highlighted the lack of trauma data analysis in North Queensland and appealed for a greater emphasis on collecting more robust patient records as vital for driving effective change.
Dr Clinton Gibbs from RSQ said one objective of the study is to conduct a comprehensive analysis of clinical interventions and therapies from point-of-injury to hospital care, across multiple healthcare providers.
“Rescues often occur over vast distances, with wait times up to 12 hours, or longer, making crucial treatment in the first ‘Golden Hour’ - the vital first hour after injury - virtually impossible.
“We’re looking to shift the focus of emergency treatment in remote areas from ‘scoop and run’ to ‘continuum of care’, which has many moving parts, and is overseen from a centralised base in Townsville,” Dr Gibbs said.
He said optimal patient outcomes critically depend on skilled personnel and resources, and accurate record keeping at every stage of treatment.
“Poorer outcomes in the north, for example, may not be due solely to longer retrieval delays. They may also arise from inefficiencies in the chain of survival, that we hope to shed light on with our study,” he said.
The JCU scientists have also been working with US Department of Defense for a decade in developing new drug therapies for pre-hospital trauma in military far-forward environments to treat trauma at the point-of-injury.
“It’s possible these drugs could be kept in healthcare facilities scattered throughout rural and remote regions of Australia, and administered early via telehealth from a centralised base to treat head injuries, haemorrhage, infection and burns to improve current outcomes. This is the future we are hoping to create, and it will be accessible to all Australians,” Dr Letson said.
Trauma care in the tropics: addressing gaps in treating injury in rural and remote Australia: https://pubmed.ncbi.nlm.nih.gov/35065592/
Queensland’s Emergency Medicine Foundation (EMF):
Professor Geoffrey Dobson
Dr Hayley Letson