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 joint trauma audit meeting of Departments of A&E and Surgery
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 by Department 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 with presentation of combined data 
Apr 2005 Commencement of Trauma Diversion Scheme in Hong Kong West Cluster
May 2006 Establishment of "TBI" calling system for managing patients with traumatic brain injury

Second 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 Prince of Wales Hospital
Aug 2009 First Advanced Trauma Care Workshop
Jul 2010 Third 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 Setup of Guideline for “Whole Body Computerized Tomography (for adult patient)” 
2011 Trauma Transfusion Protocal

Transamine Protocol
2013 First Multi-centered Review Meeting (all 5 TCs in Hong Kong)
2014 Prothrombin complex concentrate protocol

Airway Management Flowchart and set up of 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
Dec 2019 CRM simulation training co-organized with Q&S Team of Hong Kong West Cluster 
Mar 2023

Associate Nurse Consultant (Trauma Service) in post

Setup of workflow of Critical Trauma Patient Flow after Operation 

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. 

Members and Co-opt Members : Representatives from Clinical Departments

Dr. Wing-Chiu DAI Consultant, Director of Trauma Service
Department of Surgery (Chairman)
Dr. Theresa LI Cluster Chief Executive
Hong Kong West Cluster
Dr. Tat-Chi TSANG Chief of Service
Department of Accident & Emergency
Dr. Andy NG Associate Consultant
Department of Anesthesiology
Dr. Alfred WONG Associate Consultant
Department of Intensive Care Unit (Adult)
Dr. Lai-Fung LI Consultant
Department of Neurosurgery
Dr. Colin YUNG Resident Specialist
Department of Orthopaedics & Traumatology     
Dr. Kelvin CHOI Associate Consultant
Department of Radiology
Dr. Carolette GROENEWALD      

Department of Surgery

Ms. Heidi WONG Nurse Consultant
Trauma Service
Ms. Celestine NG Associate Nurse Consultant 
Trauma Service
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 300 items relating to demographic, assessment, resuscitation, outcome/ complications and follow up. Data collection is done by the Trauma Nurse Coordinator.

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
Training and Development
  • Support trauma team members to attend ATLS, ATCN, TCAR
  • Arrange Crew Resource Management Simlations training co-organized with Q&S team of HKWC
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 A&E Dept. > 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 Outcome after operative intervention for traumatic brain injuries elderly

Asian Journal of Neurosurgery
[2017; 12(1): 37-43]

PMID: 28413530

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

European Journal of Trauma and Emergency Surgery  Published on line: 3.3.2020

2019 RISC II is superior to TRISS in predicting 30-day mortality blunt major trauma patients in Hong Kong

European Journal of Trauma and Emergency Surgery

2022 Epidemiology and change in pattern of traumatic injuries in children visiting emergency departments during COVID era in Hong Kong: A retrospective single-institutional serial cross-sectional study Poster presentation in the 9th Congress of the European Academy of Paediatric Societies on 7-11 Oct 2022