Data from LAS demonstrates that the St Mary’s MTC consistently receives around 35% of all patients in London who trigger the Major Trauma Tool. The department is seeing now over 3000 trauma calls per annum, and around 700-800 patients in the most injured category (Injury Severity Score ISS >15). The unit was fundamental in managing trauma patients affected by the 2017 major incidents across London.
St Mary’s Major Trauma Service consists of Consultants drawn from General Surgery, Vascular, Neurosurgery, Orthopaedics and Plastics services across Imperial, contributing to a Surgeon of the Week model. The service is supported by Consultants and Registrars from neurosurgery, cardiothoracic, anaesthetics, radiology, intensive care, plastics, vascular, general surgery, and visiting consultants from other specialist centres to support burns and maxillofacial requirements.
Following a review of trauma services across London led by Healthcare for London, the Joint Primary Care Trusts Committee agreed that four Major Trauma Centres and associated Trauma Networks should be established in London. The Major Trauma Centre based at St Mary’s Hospital is the hub for the North West London Trauma Network.
The post holder will be expected to gain experience in the acute and ongoing management of severely injured patients, including the ability to provide damage control surgery to the chest, abdomen and vascular systems . Although bone injuries are part of the trauma system. The aim is to allow the Fellow to become proficient in the evaluation of critically-ill and severely injured polytrauma patients; providing leadership which facilitates the interaction within the entire team of caregivers and with the patients and their families.
There is a growing emergency surgery service at St Mary’s Hospital. With other Senior Fellows, the post holder will rotate to join the consultant of the week for General Surgery to provide acute surgical care to non-selective surgical emergency take. This will include the initial assessment of non-trauma surgical emergencies in the Emergency Department, Surgical Assessment Unit, as well as day-to-day management of admitted patients. It is anticipated that the post holder will assist the consultant in supporting the coordination of NCEPOD operating sessions along with the on call Specialty Registrar for Surgery.
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1. General responsibilities
To gain experience and become competent in the management of the trauma patient, particularly the management of penetrating and blunt trauma, whilst continuing emergency work in their base speciality.
To gain operative/clinical competencies at the management of the poly-trauma patients.
To undertake a research project during the fellowship period.
To participate in formal and informal teaching of junior doctors, medical and nursing students and paramedics.
2. Operative/Clinical Exposure
On average a fellow is expected to assist in the management approx. 500-600 major cases with a mix of blunt and penetrating trauma as described above.
The fellowship is a one-year program involving patient care, research, and education. The program may include the following rotations:
Trauma surgery
- Chest and abdominal trauma
- Vascular Surgery
- Cardiothoracic Surgery
- Neurosurgery
- Plastic Surgery
- Orthopaedic Surgery
Electives (Trauma Radiology, Trauma Anaesthesiology, Emergency Medical Services).
6. Daytime commitments
- ICU & Major Trauma Ward multidisciplinary ward round
- Attendance at trauma calls
- Prioritise and organise trauma operating
- Experience in emergency neuro-surgical theatres
- Attendance at multi-disciplinary trauma follow-up clinic
- Attendance at out of hours trauma calls penetrating, code red and at the discretion of the Trauma Team Leader.