The National Institute for Health and Care Excellence (NICE) has issued a new quality standard which focuses on assessment and management of trauma in all age groups, which includes complex and non-complex fractures, major trauma and spinal injury. Hip fracture and head injury are not within the scope of this quality standard.
The quality standard covers the following 6 recommendations:
- Individuals with major trauma unable maintain their airway and/or ventilation should receive drug-assisted rapid sequence induction of anaesthesia and intubation within 45 minutes of presenting to the emergency services.
- Individuals receiving an urgent 3D imaging for major trauma should get a provisional written radiology report within 1 hour of the scan.
- Individuals with open fractures of long bones, hindfoot or midfoot should receive fixation and definitive soft tissue cover within 72 hours of injury, if unable to perform along with debridement.
- Individuals with full in-line spinal immobilisation should undergo a cervical spine injury risk evaluation using the Canadian C-spine rule.
- A dedicated trauma ward for individuals with multisystem injuries and 24×7 availability of a designated consultant is necessary at major trauma centres.
- Acute specialist services for post-trauma rehabilitation, and for children and the elderly should be available at all major trauma centres.
Health professionals should also take into consideration quality standards on ‘Rehabilitation after critical illness’, ‘Blood transfusion’, ‘Intravenous fluid therapy in children and young people in hospital’, ‘Falls in older people’, ‘Head injury’, ‘Intravenous fluid therapy in adults in hospital’ and ‘Hip fracture in adults’ when providing services for trauma.
