Emergency: The London Major Trauma System

Channel 4's documentary on the London Major Trauma System - Emergency - returned for a second series of four episodes in August. If you missed it, you missed out!

You can watch all four episodes on Channel 4.

Teacher's should use their professional discretion when deciding to show or recommend this TV series to their students.

What is Major Trauma?

Trauma refers to injury to the body; when an individual is harmed during an incident that results in multiple wounds or serious injuries that could result in death or serious disability, it is known as major trauma.

The types of incidents that cause major trauma are things like stabbings, head injuries, serious car accidents or falls from height.

Facts about Trauma

• Trauma is one of the major challenges of modern society. It kills 6 million people a year worldwide and 16,000 in the UK – and this number is rising.
• Trauma is the leading cause of death in those under the age of 44.
• For every trauma fatality, between three and four patients survive with a serious or permanent disability
• The London Major Trauma System is a unique network of 39 hospitals made up of 4 major trauma centres and 35 trauma units, ambulance services and air ambulance services.
• It was set up in 2010, celebrating its 10-year anniversary in 2020
• The four major trauma centres are all based in London and sit at the heart of a regional network.
• The LMTS has improved survival rates for major trauma patients by 50%.

Source: Facts about the London Major Trauma System (Channel 4)

What makes the London Major Trauma System Special?

The key to the success of the London Major Trauma System (LMTS) is collaboration.

The London Ambulance Service works hard to categorise calls that come into the 999 service, so that major traumas are quickly identified and affected individuals taken to the right locations as quickly as possible.

A vital part of the LMTS is pre-hospital emergency care. If the 999 service categorises a call as a major trauma, they will send consultants that specialise in pre-hospital emergency care, often in a helicopter via the London Air Ambulance, to the scene.

They are also joined on scene by advanced paramedics. This ensures that individuals with the most serious injuries receive life-saving care and treatment even before they reach the major trauma centre.

The four hospitals that make up the LMTS are:

• The Royal London Hospital - covering North East London and Essex
• St George’s Hospital - covering South West London and Surrey
• King’s College Hospital - covering South East London, Kent and Medway
• St Mary’s Hospital - covering North West London

These hospitals are individually known as major trauma centres.

What they have in common, is an accident and emergency department that can assess, diagnose and treat the most serious cases 24 hours a day, 7 days a week.

They have multiple expert clinicians on site at all times, such as emergency consultants, anaesthetists and surgeons of various specialities such as orthopaedic, plastic and vascular surgery. They have experienced and specialist nursing teams, as well as allied health professionals such as radiographers and access to the very best diagnostic equipment, such as magnetic resonance imaging (MRI) scanners.

All of these professionals work together as a multidisciplinary team, to provide the very best outcomes for seriously hurt individuals facing life changing injuries or even the possibility of death.

These hospitals also have specialist doctors and wards for ongoing care once the immediate emergency situation is dealt with, such as intensive care, orthopaedics and neurology, with access to a whole range of clinicians, nurses and allied health professionals to support recovery and rehabilitation.

Multidisciplinary Team Care: Zoltan

In episodes 2, 3 and 4 we learn about Zoltan and witness first hand the power of collaboration in the healthcare sector.

Zoltan was injured on the streets of London when a van hit him at speed and knocked him down into a basement area, causing serious crush injuries to his foot and lower leg.

• At the scene of the accident: He was treated by the London Air Ambulance and London Ambulance Service paramedics, before being rushed to St Mary's hospital.
• In A&E: Zoltan was assessed by a multidisciplinary team of doctors who needed to make immediate decisions about how best to care for him, supported by nurses and healthcare assistants and allied health professionals such as the diagnostic radiography team.
• In emergency surgery: Zoltan had emergency surgery to amputate his leg, as the crush injury was so severe that his leg could not be saved. This had to be done quickly to avoid major blood loss and to prevent infection from developing.
• Multidisciplinary team meeting: A large group of healthcare professionals met to discuss Zoltan's ongoing plan of care, discussing both physical and psychological concerns.
• Further surgery: Zoltan underwent further, planned surgery, to ensure that his leg would be comfortable and stable enough for him to use a prosthetic (artificial) leg, so he can continue to be independent, return to work and enjoy life. The surgery was carried out by both orthopaedic (bone) surgeons and plastic surgeons - responsible for ensuring that the tissue and skin of the leg is maintained. They are supported by a large theatre team, including nurses and operating department practitioners.
• Rehabilitation: Zoltan had extensive support from the physiotherapy team whilst in hospital to help him maintain his mobility in the short term and then from a specialist physiotherapist to teach and support him to walk on his prosthetic leg.