Aim

Assess efficacy of caudal epidural injection with epidurogram with validated outcome measures.

Introduction: Trauma constitutes a substantial portion of the workload of any Trauma and Orthopaedic department and any attempt for improvement in service is warranted. Aim of this study was to compare a New with an Old Trauma Service Protocol, by means of quality of Clinical service, junior doctors training and financial impact.

Methods: Search was performed through the HISS archives and the theatre registry. Quantitative and qualitative parameters were assessed.

Wait till surgery, length of patient hospitalisation, out of hours surgery, case cancellations, complications and number of procedures performed by junior doctors were all compared. Medical and nursing staff members were interviewed regarding their subjective opinion for the two protocols.

Results: Length of wait to surgery was substantially decreased for most of the fracture groups. Out of hours surgery were almost eliminated and there were hardly any cancellations for reasons other than medical. The number of trauma cases performed by junior doctors was increased and there was always performed under supervision. The total length of stay for all the trauma patients was substantially decreased in the second year. All health professionals quoted improvement of their working-lives with less stress and better organization. The financial impact was less than we thought.

Discussion: Within a patient focused NHS all patients deserve the best of care that could be provided; implementing proper resources for Trauma service should be one of our first priorities in the Bone and Joint Decade.