NZ trauma care gets 'B-minus' rating

A leading specialist has rated New Zealand's trauma care system as "B-minus".

Auckland City Hospital trauma services director Ian Civil said significant improvements were needed in the development of trauma care.

Mr Civil is chairman of the Royal Australasian College of Surgeons New Zealand trauma committee.

"If we are going to look after trauma patients effectively, we need to make sure our pre-hospital care is well-coordinated with hospital care and rehabilitation," he said before the college's annual scientific meeting, which began yesterday in Auckland.

Mr Civil said the college's New Zealand trauma guidelines supported a tiered system with most of the major cases managed in an advanced trauma service in one of the major centres, similar to the arrangement in the Australian state of Victoria.

"Although we often talk about the effective road safety initiatives of our Victorian neighbours, we have done little to emulate their success, particularly in the development of a national trauma plan, the designation and development of trauma care centres, quality assurance, a trauma registry, education systems, and ongoing research into the treatment of trauma," he said.

On any given day New Zealand, trauma patients were sitting in acute hospital beds when they should be being rehabilitated.

"In Victoria rehabilitation specialists come right into intensive care and select patients for early rehabilitation. Here patients are sometimes sitting around for several weeks."

However, he noted that the success of injury prevention initiatives over the past decade had raised a new challenge for trauma surgeons - a lack of cases.

"Because trauma is not as common as it used to be, we can't always train new surgeons on the job."

When he was a trainee, he probably worked on three or four major trauma cases a day, Mr Civil said. Now there were probably fewer than one a day in his unit.

"Our injury toll peaked in the 1980s. Since then injuries have been constantly peaking down."

- NZPA