The organisation of trauma services for rural Australia

Abstract

This review discusses the development of trauma care and the retrieval process in Australia, particularly as it impacts on the rural population. In rural and remote settings, trauma is a major cause of death and disability with the death rate from injuries increasing with progressing remoteness. Time is a critical factor in trauma care and the length of time it takes to reach definitive care has a significant impact on patient outcome. In rural areas people have difficulties accessing medical services within a reasonable time period and the delays associated with the provision of trauma care contribute to an unacceptable level of mortality and morbidity. Since it is impractical to provide sophisticated medical services capable of managing severe trauma in rural areas, referral and retrieval form a vital part of the process of rural trauma care. The focus of this review is the management of severe trauma in rural areas. It will discuss the utilisation of clinical guidelines to improve the process of trauma care and examine if they can be used to reduce the time taken by rural health facilities to seek advice and request retrieval services. The evolution of trauma care in Australia, including the referral and retrieval processes, will be discussed and strategies aimed at improving tertiary hospital referral identified.