Uncharted territory: navigating a level one trauma service during a global pandemic

As a level one major trauma service, the RMH sees more than 4000 injured patients each year. One of the changes that came with Melbourne’s lockdowns throughout 2020, was a 34% decrease in trauma patient presentations.

Head of Trauma Dr David Read explained that while the decrease in patients was expected given the nature of the lockdowns prohibiting people from leaving their homes, the complex environment of delivering care through a pandemic created its own set of challenges.

“Patients were scattered around the hospital depending on their COVID status, which meant ward rounds remained lengthy despite the reduced numbers, we also had to stay diligent with continual donning and doffing of personal protective equipment (PPE) which added to the time it took to treat patients,” David said.

A study, led by the RMH trauma team, published in the Royal Australasian College of Surgeons journal, found that despite the impact of COVID-19 on the health system, the quality of care within the trauma service was not affected.

Trauma Program Manager, Kellie Gumm, explained that the duration from admission to CT scan, and to the operating theatre was not compromised, and sometimes faster.

“It shows we were able to quickly adapt and change with the challenges that COVID presented to our service,” Kellie said.

One of the biggest challenges the hospital faced were healthcare worker infection rates and subsequent staff that were furloughed.

“During that time trauma patients were admitted based on suspected COVID status, rather than their injury status, meaning they were often cared for by nurses and allied health staff less familiar with caring for a injured trauma patient,” Kellie said.

While the health system had to move quickly to keep up with the changing nature of COVID outbreaks, the research found the importance in maintaining the trauma and surgical emergency response.

The fatality rate for COVID-19 is 3.1% and for major trauma patients it is 10.4%.

“So while the pandemic is far from over, it’s very important to keep in mind with future responses to COVID or other pandemics, how important maintaining our trauma service is, it’s great to see that we have been able to maintain our level of service during different peaks of infection rates,” David said.