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Hello. My name is LJM Ultram. I'm one of the critical care and I'm ecstatic consultants here on Together with She Need Cambell Gray. He's one of the emergency medicine physicians on hands doctors. We run the ball fast Drama team education Course. These videos form part of hybrid course where we are showing videos before you come to face to face simulation. We're looking forward to see at the first course on the 10th of June. Of course, that formal works best If you get to see all of the news, understand the theory off the drama team before you arrive with us and then we can maximize our time with face to face simulation. The AM over the Bell Tech horse is really to train and multi professional team heart apply there trauma skills together and so that that comes from major trauma patients can be improved. And I work here in the critical care building on Levels five and six where we have ice tea beds, the bottom of this building. We also have an emergency department and then the major trauma ward is also okay. Did there. So when I have the infrastructure and the Royal site here of the major trauma center, where we can deliver at trauma care and as well as buildings and infrastructure, though we need the people on the processes that alliance look after trauma patients on the trauma team is very much central to that. But how did we start all of this essentially in 2000 and 15, when there was no trauma team on wasn't actually really a trauma system for us to work within. It was very much a case of building a team from scratch on. To start with, we had to define the group of patients we were talking about and we're talking about major trauma patients with an injury severity score off over 15. Any major trauma is a life changing injury. Trauma is the biggest cause of death in the under 44 is globally. On the off on a trauma team on the trauma system within which we work is to reduce mortality on long term disability. For these patients, this isn't a site and we work right the injury severity score and by adding up the three highest a previous did injury scores and on three of these six areas listed so abbreviated injury score is essentially a scale that allows us to cold injuries from minor giving at school one to sex, which is virtually unsurvivable. And then those are attributed to each of the six areas listed had a neck injury, facial injury, Grastek, abdominal extremities or external injury. And as I said, You square then on your abdomen, the highest injury severity school being 75. This is the kind of data this input to the Times drama all the research network on Del Abyss that allies off state actually compare. All right comes and see how well we're doing compared to others in the UK Did we really have a truck problem with trauma? And prior to setting up the trauma network on the trauma team? Well, local data suggested that we did on. We have benchmark data from on and see People report, which came out, and you guys in seven and across the UK showed that there were significant concerns about no only the clinical but the organizational aspects of care for these patients very much because there's so many teams involved in these patients on, they are so complex compared to those benchmarks that we're living in the report and in Northern Ireland here, the Royal and we fell short somewhat, for example, consultant leadership in the emergency department. And the target was 95% for trauma patients on then the Royal. It's around 70% equally time. Spend a needy was far too long, ranging from 15 minutes to 10 or 20 minutes, with the median time 4.5 ours. Our use of trauma imaging was also relatively per for those with extracranial injuries or by if you have, ah, no systolic BP or lactate it over four on a significant abdominal injury, you should have a laparotomy or CT on within an hour of attendance. That was the benchmarks that back in 2000 and seven Andi, even in 2014 2015, we were falling short with only a third of our patients receiving this. And so the completion of the trauma audit northern and showed that we spent too much time in the D. We needed seeing your doctor involvement and decision making for these patients, timely diagnostics and all the above required a team approach. We know that the trauma team of the survival exists And as it does of course, for a possible cardiac arrest for stroke patients. We need to bring our trauma patients to the correct facility and timely manner, whether by helicopter or not, um, transfer. We need them to receive early results, stint of measures, early diagnostics, early advanced surgery on critical care and then early rehabilitation. We're doing that now. I within the Northern Ireland Major trauma Network, whereby we have this hub on spoke model and the major trauma center being, of course, the Royal and then trauma receiving you started throughout the province. You can make more about that on the major trauma network website, we knew that trauma network and management of patients see his lives both in the UK but also globally or by if you live in the state. In America, where there's a trauma network and your chance of death is, you're just by 9% for me to trauma. In the next video, we're going to look at high. The trauma team is activated on who it's actually composed off