Major trauma in Victoria

In Victoria, the state trauma system responds in a coordinated way to provide immediate care to anyone experiencing a major trauma event.

The ongoing coordination of the Victorian State Trauma System (VSTS) is co-funded by the Department of Health and Human Services (DHHS) and the Transport Accident Commission (TAC) to ensure major trauma patients are managed in the best possible way.

The objective of the VSTS is to reduce preventable death and permanent disability and improve patient outcomes by matching the needs of injured patients to an appropriate level of treatment in a safe and timely manner.

Major trauma services care for people who have experienced severe injury that results in emergency care at a hospital. Major trauma is described as injury resulting in admission to an intensive care unit for more than 24 hours and any serious injury that satisfies the Victorian State Trauma Registry patient criteria.

The main causes of major trauma include:

• road traffic or transport related accidents
• low and high falls
• being struck by an object or person (for example, an assault)
• self-harm
• burns
• horse related injuries (for example, falling from a horse).

Major Trauma services

When a serious accident or incident occurs, Victorian health services follow agreed procedures to respond as quickly as possible.

A person who experiences a major trauma event may be transported by helicopter, ambulance or other vehicle to a major trauma hospital or the person may go to a hospital or other healthcare service to be stabilised before being moved to a hospital with specialised major trauma services.

The process of triage (pronounced "tree-arj") is used to work out how serious a persons' injuries are in order to provide the best, most immediate care possible. If there is a traumatic event with many people injured then triage is used to give the most seriously injured patients priority.

In Victoria there are three hospitals specifically catering for major trauma patients, these Major Trauma Services (MTS) are:

• Royal Melbourne Hospital trauma service
• Royal Children’s Hospital trauma service
• The Alfred Hospital emergency and trauma centre

Three metropolitan health services provide neurosurgical services other than the MTS noted above:

• Austin Hospital - provides specialist trauma care to patients with an isolated spinal injury
• St Vincent’s Hospital - provides specialist trauma care to patients with isolated injuries requiring microsurgery
• Monash Medical Centre.

Regional hospitals include:

• Ballarat Base Hospital (Regional)
• Bendigo Hospital (Regional)
• Barwon Health, Geelong (Regional)
• Latrobe Regional Hospital, Traralgon (Regional)
• Goulburn Valley Health, Shepparton (Regional)

Rural and regional healthcare services for major trauma incidents

If someone experiences a major trauma incident in a rural or regional location they may be transferred to a local hospital to be stabilised before they are transferred to a major trauma hospital. They may then be transferred to a rehabilitation service from hospital or recover at home.Read more about Victorian regional trauma services on the health.vic website.

Major trauma patient pathways

Every patient is different and their recovery is different, however, there are some general pathways people will follow after a major trauma incident. Major trauma patients usually go from the site of the trauma, via ambulance, to an emergency department for stabilisation. They then have surgery, or a stay in an intensive care unit. When their condition is stable, they go to an acute hospital ward, then possibly to a rehabilitation ward or to an external rehabilitation service, before returning home.

At home, they may still be cared for by clinicians or attend outpatients clinics or see private therapists. There is a coordinated process to help people move from hospital to rehabilitation services or to their home. People recovering from a serious trauma follow different paths through rehabilitation and recovery after their time in hospital.

A person's recovery is based on:

• the severity and type of injury they have sustained
• their previous health status
• whether they have support from family, friends, healthcare and community services
• their mental health.

Not everyone fully recovers. People who have suffered a serious trauma may sustain lifelong disabilities such as a brain injury or physical disability. A person's mental health may be affected in the short or long term.

Families may be affected by financial and mental health issues too; relationships can change or end.

After hospital services for people who have experienced major trauma

After a patient has recovered sufficiently, and when their healthcare team has agreed, they will be discharged from hospital and transferred to either a rehabilitation service, their home or a care service.

A range of specialist rehabilitation services, as well as a wide range of support services, can then assist with further recovery and adjustment. Some services and supports will be organised by the hospital, others can be organised with the person’s GP. Some services, such as mental health services, may be available via phone or the internet.

Care of varying levels may still be required for either a short or indefinite period of time depending on the type of injury or disability. There is a range of services and support that are available to Victorians, either for free or at a reduced fee. Such services include home help and home modifications.

There is also a range of mental health services to support patients and their families.

Where major trauma patients recover may depend on whether they are eligible to receive compensation and the type of compensation they have, or if they have private health insurance.

A major trauma patient’s healthcare team will try to find a rehabilitation service or other healthcare services to assist them that are as close as possible to where they live. This will be dependent on the availability at the service where numbers may be limited.

Healthcare services including local GPs, community and other services can be found using the Better Health Channel’s service search tool.

Financial support following major trauma

Depending on the circumstances around where, how and why the major trauma occurred, a patient may be eligible for additional financial support or compensation. For example: The Transport Accident Commission and Worksafe Victoria provide compensation to Victorians for transport accidents and work related incidents.

People who have been the victim of a crime can apply for financial help from the Victims of Crime Assistance Tribunal(VOCAT).

Veterans can discuss compensation with the Department of Veterans Affairs.

Medicare or Centrelink may be able to assist with some financial matters, if the person is eligible. Private health insurance can also cover some costs. MoneySmart provides a free financial advice service that may be of assistance too.