C4TS SPRING 2014 NEWSLETTER
Issue 2
2
C4TS
SPRING 2014 newsletter
WELCOME
Spring has finally arrived with the start of 2014 bringing a wave of media focus on cyclist injuries and the work of the London’s pre-hospital and specialist trauma centres. A key factor in the continuous provision of world-leading injury care within our Capital is the research and educational activity of the Barts Centre for Trauma Sciences (C4TS). In this Newsletter edition we provide an overview of the challenges of conducting injuries research, results of a study assessing the impact of implementing London’s regional trauma system and feedback on the discussion and outcomes of the recent Cycling and Trauma Seminar, organised by Barts and The London Charity and chaired by John Snow.
Trauma Call
By
Claire Rourke (Clinical Trials Coordinator)
THE NEED TO STUDY TRAUMA Traumatic injury is responsible for a large proportion of the world's burden of disease, with over 5 million deaths annually and an ever increasing economic and societal impact.
To understand the body’s immediate reaction to both traumatic injury and treatment itself requires research to be conducted by dedicated staff working alongside but independent of the trauma team providing care.
Trauma is a healthcare field in which the uptake of new approaches can have an immediate and significant effect on patient outcomes, both in terms of survival and quality of life. To achieve evidence-based changes in practice that optimise patient outcome, healthcare delivery and the allocation of resources requires significant research investment, beyond that of clinical audit.
CONDUCTING RESEARCH IN THE EMERGENCY ENVIRONMENT Informed consent is a process for gaining permission before conducting research involving any person. Most potential trauma study participants will be incapacitated upon arrival at the Emergency Department. Neither they nor their relatives will be able to provide informed consent in this early stressful period. Most commonly the trauma team leader will act as a legally authorized representative, providing informed consent so enabling emergency care research to begin. However over time, there is a hierarchy of consenting that then seeks permission from the patient’s relatives and ultimately the subject themselves to continue.
Acute injuries research is challenging. By its very nature trauma is unpredictable and comprises many different types and mechanisms of injury. The patients to be studied present with critical injuries that require immediate, life- and limbsaving treatment by large specialist trauma teams.
Simon Eaglestone (Head of Operations)
Unlike most other fields of medicine trauma research requires a means to capture the unpredictable arrival of injured patients, often at night. Always having research staff available to attend a trauma call is expensive and requires close working and engagement with the trauma team.
ENSURING ROBUST RESEARCH METHODS & INFRASTRUCTURE Our trauma research activities span the whole patient journey, from injury to convalescence, and comprise multiple disciplines (e.g. emergency medicine, surgery, intensive care). This necessitates effective working across departments and with other hospitals to increase the diversity and rate of trauma patient recruitment. Whilst trauma research is difficult, we and our partner hospitals use the same clear and visible protocols and forms to ensure the robust collection, sharing and analysis of patient data and samples. Underlying all of our research activity is the drive to ensure the conduct of the highest quality research methodology, practice and governance to ensure the protection of patient confidentially and rights and the evidence-based optimisation of trauma care and patient outcomes. Click here to find out more about our research and clinical trials activities.