Trauma Care in Ontario
Just before the long weekend began, The Globe and Mail published an article called "Ontarians overestimate access to trauma care, specialist's poll shows." As timely as this article was, it raised many valid points about the state of Ontario's health care system. How many Trauma Centres do we have in Ontario? How many smaller community hospitals are equipped to handle the patients that a designated trauma centre would handle?
Dr. Avery Nathens, Trauma Director of St. Michael's Hospital, located in downtown Toronto (one of the well-known trauma centres), is the specialist who commissioned the poll referred to above. The poll reveals that 40% of poll takers felt that within an hour of calling 911, they would have access to a trauma centre. The reality is that 62% of seriously wounded adults in Ontario are taken first to their closest hospital, and 69% percent are never transferred to a trauma centre.
Dr. Nathens explained that reaching a trauma centre in that crucial initial hour might mean the difference between life and death. So, how many trauma centres do we have in Ontario? Eleven. Dr. Nathens suggests the path forward would involve training staff at smaller community hospitals to better prepare their facilities to receive patients and move them quickly to trauma centres as needed. He also states that the Health Care System itself has to be accountable in light of the fact that patients can't make the decision themselves as to where to be placed.
According to Sunnybrook- Osler's Field Trauma Triage Guidelines, patients should be taken to a trauma centre if they meet any of following criteria:
- Paraplegia or quadriplegia
- Penetrating trauma to the head, neck, trunk or groin
- Altered level of awareness
- Abnormalities in heart rate, blood pressure or respiratory rate.
The Guideline states that EMS should not spend more than 10 minutes on the scene and transport time should be less than 30 minutes to the trauma centre; if that is exceeded, the patient should be taken to the nearest hospital despite the severity of their injury. The 2011 Ontario Trauma Registry Report cited the leading causes of trauma as: car accidents, unintentional falls and injuries purposefully inflicted by other people.
Serious car accidents happen every long weekend. Sergeant Dave Woodford, of the OPP's Highway Safety Division revealed there were 9 fatalities on Canada Day weekend this year. In 2010, there were 31 fatalities over the 5 long weekends. In the GTA, this August Civic Holiday, at least 6 people were killed in fatal motor vehicle accidents. The OPP reports that 8 people died on roads, trails and waterways in Ontario this weekend. Officers laid 5,750 charges for speeding and 198 for impaired driving. Hundreds more were caught street racing or not wearing seat-belts.
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