Saturday 15 December 2018

Major trauma - why are Ireland's trauma centres taking so long to build?


Dr Michael Mosley
Dr Michael Mosley

Maurice Gueret

How come it's taking Ireland so long to come up with just two trauma centres, when the UK can build over 20 of them in three years, asks our GP, who is feeling a bit left out in the cold

The new acronym in health circles this month is MTC. That's Major Trauma Centre, and it's coming to a place near you. If you live in Dublin or Cork, that is. Three years ago, during his time as health minister, Dr Leo commissioned a report on improving the care of major trauma cases. About 30 of us become serious trauma patients every week in Ireland - motor accidents mainly, but also victims of falls, work accidents or severe violence. The first draft of the report was sent to his department a few months later, but it has taken two years before it has seen the light of day. And it's not as clear as it should be. There is going to some sort of HSE-mediated beauty contest to delay the decision on which hospital in Dublin fits the bill. There is talk of the Mater or Beaumont, but the former has no helicopter landing area, and residents near the latter are complaining already about the number of noisy aircraft setting down in the hospital's field. The decision really rests on what sort of specialists are available. Beaumont boasts brain surgeons, the Mater houses chest surgeons, and St James's looks best for plastic surgery. They all have emergency medics, orthopaedic and trauma surgeons, but a dedicated Major Trauma Unit requires 24/7 availability of each of the above specialities. With neurosurgery on site, it really has to be Beaumont that's beefed up as the MTC. But it's a sure sign of political dithering that the Cabinet didn't make this recommendation and save us all from a year of further speculation.

Yes We Can?

One specialist in the field has pointed out that in the UK they built a network of over two dozen Major Trauma Centres in just three years. That's the same length of time it took us to get a report that doesn't even decide where they are to be. The seven-year time frame announced for our two trauma centres is typical of a health service low on beds and top heavy with desks. Is feidir linn, Mr Obama? Mo thoin.

Get to Rehab

Major Trauma Centres are all very well. It would be nice for all severe cases to be seen by an experienced consultant within 30 minutes of arrival, which is a kind of gold standard for MTCs. But I do worry about joined-up care. Who gets patients there in the first place, and what happens to them afterwards? You only have to look at the recent experiences of a GP in Connemara with getting his patients to hospital, to see the problems at the transport end of the trauma scale. And on the other side, we still have Third World rehabilitation services in this country. Treatment is not intensive enough, nor is it for long enough. Irish victims of major accidents abroad are often better advised to stay in the country of their accident for rehabilitation. And would, if only their health insurers would pay.

Star Jumps

I am going to take the doctor's advice this spring and try five minutes of intensive exercise at home, a couple of days a week. The medic in question is Dr Michael Mosley, pictured above, sometimes of this parish. His recent TV programme on The Truth about Exercise certainly opened my eyes about the benefits of short, intensive exercise routines. If any tremors show up on seismographs over the next few months, don't panic. It's probably my 60 seconds of star jumps.

On The Buses

In 1949, Dr Jerry Morris conducted groundbreaking research on London buses. He concluded that sedentary drivers had twice as many more heart attacks as stair-climbing conductors. When his figures were published in The Lancet, they caused a sensation in public health. Later, he studied postmen, and concluded that those who delivered the letters fared better than those whose jobs were behind a counter. But now a Canadian study is hinting that heart disease may be twice as common in standing jobs as in sitting ones. Apparently you are at the lowest risk if your job combines standing, walking, climbing and sitting. Lying down doesn't get a mention.

Hot Jars

I don't like plugged-in blankets, so our recent bitter snap had me out searching for a new hot-water bottle. I tried six places before Hickey's Pharmacy came up trumps with a nice blue furry one. Where are they all gone? Friends tell me that I'm out of date. They heat their houses 24/7.

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