Trauma Service

The Trauma Service was formally established in Queen Mary Hospital (QMH) in August 1997. The objectives of this central service are:

1. To coordinate clinical and support departments in the delivery of trauma service;
2. To identify problems and issues of common concern in trauma, and;
3. To review, coordinate and develop guidelines, protocols and quality assurance
     programmes related to trauma care.

 

Development of Trauma Service in Queen Mary Hospital
Date Events
Jan 1995 First interdepartmental meeting on Trauma Organization and Service
Sep 1996 First Dept. of A&E and Surgery joint trauma audit meeting
Jan 1997 Inaugural Course of Advanced Trauma Life Support (ATLS) for doctors
Hong Kong Surgical Forum – Trauma Care
Apr 1997 Inaugural course of Advanced Burn Life Support (ABLS)
Apr-Jun 1997 Pilot study on early management of trauma patients carried out by the Dept. of Surgery
Jul 1997 Formation of Trauma Centre Committee
Aug 1997 First meeting of QMH Trauma Centre Committee
Sep 1997 Creation of the post of Trauma Director
First Trauma Service Executive Committee Meeting (TSEC meeting)
Oct 1997 First Interdepartmental Trauma Audit Meeting
Jan 1998 Creation of the post of Trauma Nurse Coordinator
Development of trauma registry
May 1998 Establishment of Trauma Team Activation Criteria
Apr 2003 Holding regular meetings with other 5 Trauma Centres and presented combined data
Apr 2005 Commemcing Trauma Diversion Scheme in HKWC
May 2006 Estabishment of "TBI" calling system for managing patients with traumatic brain injury
2nd Trauma Guideline for QMH - ”Guide to Trauma Service”
Sep 2008 First FAST course - Introduction to FAST scan guideline for non-radiologist
Mar 2009 Inter-hospital Peer Review with PWH
Aug 2009 First Advanced Trauma Care Workshop
Jul 2010 3rd Trauma Guideline for QMH - “Guide to Trauma Care”
Sep 2010 Joint centered ISS coding audit meeting
Oct 2010 Trauma resuscitation progress form (2nd version) in use
Jan 2011 Guideline for “Whole Body Computerized Tomography (for adult patient)” set up
2011 Trauma Transfusion Protocal
Transamine Protocol
2013 1st Multi-centered Review Meeting (all 5 TCs in HK)
2014 Prothrombin complex concentrate protocol
Airway Management Flowchart + set up Airway trolley
2016 Consultant (Trauma Service) in post
PCC protocol Ver 2.0 + Debagatrin antibody
2018 Prothrombin complex concentrate (PCC) therapy for warfarin / new oral anticoagulants (NOAC)
associated life-threatening bleeding in A&E, Ver 3.0 (Beriplex®) + Debagatrin antibody
Trauma Mobile Website in use via mobile phone
2019 Nurse Consultant (Trauma) in post
Trauma Service Executive Committee (TSEC)

With representatives from various clinical departments, the TSEC meets quarterly and directs quality improvements in the following ways:

  • Oversee and direct the development of trauma service in QMH.
  • Implementation of related guidelines and policies.
  • Review and address issues relating to structure, process and outcome for quality improvement.

Trauma Service - Dr. Wing-Chiu DAI (Director)

Members and Co-opt Members : Representatives from Clinical Departments

Dr. Wing-Chiu DAI Consultant, Chairman of Trauma Service
Department of Surgery
Dr. Tat-Chi TSANG Consultant
Department of Accident & Emergency
D. May LEUNG Associate Consultant
Department of Anesthesiology
Dr. Alfred WONG Resident
Department of Intensive Care Unit (Adult)
Dr. Wai-Man LUI Chief of Service
Department of Neurosurgery
Dr. Tak-Wing LAU Consultant
Department of Orthopaedics & Traumatology
Dr. Vince LAU Consultant
Department of Radiology
Ms. Hay-Tai WONG Nurse Consultant
Trauma Service (Secretary)
Trauma Registry

It is a systematic collection of data from medical and nursing records of major trauma cases attended and/or admitted to QMH. It consists more than 250 items relating to demographic, assessment, resuscitation, outcome/ complications and follow up. Data collection is done by the Trauma Nurse Coordinator.

Calling System for Major Trauma in QMH
 
With effective from 1.2.2018

With effective from 1.2.2018


Interdepartmental Trauma Audit Meeting: Bi-monthly

It is a multi-disciplinary case review meeting for quality improvement, experience sharing and staff education.

Chairman: A representative from Clinical Department of A&E, Surgery, Anaesthesiology, Orthopaedics, ICU or Neurosurgery.

Participants: Medical and nursing staff from concerned clinical departments in QMH and other hospitals.

Organizing: Representatives from Departments of A&E, Surgery, Diagnostic Radiology and Trauma Nurse Coordinator.


  • Statistical report
  • Case review and discussion
  • recommendation for quality improvement

Program:

Scenario Drill

It is a multi-disciplinary drill organized and conducted by the Accident and Emergency Department and ICU.

Trauma Service Audit

With the aim to improve quality, trauma service auditing is a systematic critical analysis of the quality of care through setting agreed standards, measuring performance concurrently or retrospectively, comparing performance with standards, identifying the need for improvement and implementing changes.

Currently, some clinical audit activities are in progress, they include:

  • Appropriateness of trauma team activation
  • Trauma team response time > 15 minutes
  • Delayed diagnosis (delay in diagnosis for non-musculoskeletal injuries > 24 hours after arrival)
  • Delayed operations (delay in major operations: craniotomy, exploratory thoracotomy, laparotomy > 4 hours after admission)
  • Confidential peer review of problematic cases
  • Trauma deaths
  • Trauma record documentation
  • Staying time in AED > 2 hours
QMH Trauma Centre involved Study
Year Topic Publication / Presentation
2007 Early reports from the five trauma centres in Hong Kong HA convention 2007
2008 Injury Severity Score (ISS) vs. ICD-derived Injury Severity Score (ICISS) in a patient populateion treated in a designated Hong Kong trauma centre McGill Journal of Medicine [Vol. 11(1) 2008]
2008 Trauma-related accidents on Hong Kong Island MVC symposium Nov 2008
2009 Pedestrian Injuries in an ageing society: Insights from hospital trauma registry The Journal of TRAUMA Injury, Infection, and Critical Care [Apr 2009]
2009 Return-to-work as an outcome measure of trauma service --- a single-centre pilot study Final write-up
2010 Outcome of severely injured trauma patients at a designated trauma centre in the HKSAR Chinese Medical Journal [2010;123(10):1251-54]
2010 The first five years since trauma centre designation in Hong Kong Singapore Trauma Symposium 2010
2010 Joint study in Trauma data Hong Kong vs. Singapore Data analyzing
2010 Functional survival after acute hospital admission for severe head injury at a trauma centre in Hong Kong Under review by Asian Journal of Surgery
2011 View Annual Report ---
2011 Impact of a multidisciplinary trauma team on the outcome of acute subdural haematoma Injury, Int.J.Care Injured 43(2012)1419-1422
2012 The Diagnostic Accuracy of Focused Abdominal Sonography for Trauma in blunt abdominal trauma patients in a local trauma center of Hong Kong Chinese Journal of Traumatology 2012;15
2013 Implementation process of a Trauma Transfusion Protocol in a trauma centre in Hong Kong Poster presentation in Society of Trauma Nurse Conference, USA, 2013
2013 More than a ratio: A review of Trauma Transfusion Protocol in Queen Mary Hospital Poster presentation in HA convention 2013
2014 Management of liver trauma:10-year experience in a trauma centre Poster presentation in Singapore Trauma Conference 2014
2014 Diagnostic accuracy of Focused Abdominal Sonography for Trauma in blunt abdominal trauma patients in a trauma centre of Hong Kong Poster presentation in Singapore Trauma Conference 2014
2014 Secondary trauma diversion: what are the reasons? Poster presentation in Singapore Trauma Conference 2014
2014 HMRF study - Measuring the Hong Kong Population Burden of Injuries ---
2014 TMH Massive Transfusion Protocol ---
2014 Epidemiology of paediatric trauma in Hong Kong: A multicentre cohort study Clinical Epidemiology and Global Health 7 (Mar. 2019) 71–78
2014 Outcome after operative intervention for tramatic brain injuries in the elderly Asian Journal of Neurosurgery, 2015
2015 Review of casualties transported via private ambulance service to a local trauma centre in Hong Kong Poster presentation in Singapore Trauma Conference 2015
2016 Three-in-one protocol reduces mortality of patients with haemodynamically unstable pelvic fractures—a five year multi-centred review in Hong Kong International Orthopaedics; Feb. 2018
2017 A Comparison of Major Trauma Care in Hong Kong and Germany ---