3D.003 Assessment of trauma patients for the development of trauma protocol in Nepal

Background National Trauma Center is the only specialized trauma care hospital in Nepal in operation since 2012. In absence of a standard, trauma care protocol, the patients attending the hospital are separated by a team of medical officer and nurses at Emergency Department into four colour-coded triage categories of Red, Amber, Green and Black. This study contributes to the development of a standard trauma protocol by assessing the injuries and outcomes of the patients. Methods We included all patients presented Emergency Department with at least one trauma during Jan 2019 to Dec 2019. Patients Demographic details, vitals, laboratory tests, radio imaging records and clinical examination were entered in hospital software and stored in the hospital database. The data were extracted from the database with the permission of the hospital authority. Results Total of 18,985 patients was presented in the emergency department with different types of injury. Among them, 2,663 (14.0%) were needed special care and treated in inpatient wards. Fall and road crash comprised almost 80% of admitted cases. Mortality was 2.1% of admitted patients, mostly with head injuries followed by multiple injuries. Conclusion Disproportionately high cases of fall and road crash warrant a standard protocol for treating them. The proportion of death is also significant which indicates a need for ambulatory Emergency Medical Services in order to stabilise patients. Learning Outcomes If there were a standard protocol for trauma management mortality could be minimised.