Inclusion Criteria The Trauma Audit & Research Network (TARN) Data Collection session

The decision to include a patient should be based on the following 3 criteria being met: 1.Trauma patients: Irrespective of age 2.Who fulfil one of the following length of stay criteria:  In hospital for >3 days  Admitted to a Critical care area (regardless of LOS)  Transferred out for specialist care or repatriation* (total LOS >3days)  Transferred in for specialist care or repatriation* (total LOS >3days)  Deaths (including deaths in ED, even if COD is medical) *Patients admitted under care of Rehabilitation team only: Not included in TARN 3.AND whose isolated injuries meet one of the following criteria>>>

HEAD Injuries IncludeExclude (in isolation) Skull fractureScalp injuries Traumatic haemorrhageSpontaneous haemorrhage (stroke, aneurysm ) Brain ContusionLoss of consciousness Brain Laceration/penetration Traumatic Brain swelling Vascular injury Nerve injury Diffuse Axonal Injury (DAI)

FACIAL Injuries IncludeExclude (in isolation) Unstable fracture (usually fixed in theatre) Skin injuries Orbital Blow out fractureClosed/stable fracture/s (even if multiple) Le fort fracture (I, II or III)All other injuries to eye Pan-facial fractureAll injuries to ear Vascular injury Nerve injury Eye Avulsion Traumatic Retinal detachment Globe rupture

NECK Injuries IncludeExclude (in isolation) Vascular injurySkin injuries Organ injuryNerve injury Hyoid fracture

THORACIC Injuries IncludeExclude (in isolation) Vascular injurySkin injuries Organ injury Rib fracture/s Flail chest (unstable chest wall) Haemothorax (blood in thorax) Pneumothorax (air in thorax) Haemomediastinum (blood in mediastinum) Pneumomediastinum (air in mediastinum) Sternum fracture

ABDOMINAL Injuries IncludeExclude (in isolation) Vascular injurySkin injuries Organ injury (contusion, laceration, transection, avulsion, perforation, rupture) Retroperitoneal haemorrhage

SPINAL Injuries IncludeExclude (in isolation) Vertebral fractureSpinal strain (whiplash) Vertebral dislocationLigament Disc injury Nerve root injury Cord injury

FEMORAL Injuries IncludeExclude >65 years old Hip fractures: Neck of Femur, Intertrochanteric, Pertrochanteric or Greater trochanteric: Aged <65yrs old Hip fractures: Neck of Femur, Intertrochanteric, Pertrochanteric or Greater trochanteric: Aged >65yrs old Distal or Proximal or Shaft or Subtrochantic #: Any age Femoral Vessel injury Femoral Nerve injury

PELVIS/ACETABULUM Fractures IncludeExclude >65 years old Acetabulum fractureSingle pubic rami fracture Ischium, Sacrum, Coccyx or Ileum Single pubic rami fracture <65 Multiple pubic rami fractures Symphysis pubis joint injury Sacro-iliac joint injury (SIJ) Lateral compression fracture (LC1-LC3) Anterior posterior compression fracture (AP1-AP3) Open Book fracture Vertical Shear fracture Malgaigne fracture

UPPER LIMB or LOWER LEG Injuries Excluding hands & feet IncludeExclude (even if multiple) Open fractureClosed fractures &/or dislocations of 1 limb (even if multiple) Total Crush injuryAll other Nerve injuries Traumatic AmputationMuscle injury Multiple limb fractures &/or dislocationsTendon injury Transected vesselsLigament injury Sciatic Nerve injurySprain

HANDS & FEET Injuries IncludeExclude (even if multiple) Crush of entire Hand (including carpals, metacarpals and phalanges) Hand or Foot fracture/s Crush of entire Foot (including tarsals, metatarsals and phalanges) Crush: Digits alone Amputation: entire Hand or entire Foot Amputation: Digits alone All other digit injuries Crush = Total destruction of bones, vessels/nerves & soft tissue

BURN or INHALATION Injuries IncludeExclude (in isolation) Full thickness burn (Not treated at Burns unit) Any burn (Treated at Burns unit) >10% TBS burn (Not treated at Burns unit) Inhalation injury (Treated at Burns unit) Inhalation injury (Not treated at Burns unit) <10% burn

OTHER INJURIES IncludeExclude (in isolation) Electrocution injuriesBruises Full thickness FrostbiteAbrasions Asphyxia (hanging or strangulation)Minor Skin lacerations DrowningMinor Penetrating Injuries to skin Skin lacerations: Blood loss >20%Hypothermia Penetrating injuries to skin: Blood loss >20% Once one injury is TARN eligible. All injuries must be documented in the submission.

Inclusion Criteria: Quiz 1. Should you include? 50 year old Tripped Injuries: Closed fractured tibia & fibula on left Died after 2 days Answer: No Injuries must meet criteria, regardless of outcome Answer: Yes 65+ Neck of Femur # with any other (non Hand or Foot) fracture is included. 2. Should you include? 67 year old Fall over rug In hospital for 4 days Injuries: Right # Neck of Femur & Right Radius # 3. Should you include? 28 year old Crushed fingers in lift door In Hospital for 6 days Injuries: Fracture to Metacarpals 2+3 on left. Answer: No Injuries to digits alone are not included in TARN (including crush)

Inclusion Criteria: Quiz Answer: No: Only include if definitely Traumatic, with Date & mechanism of trauma. Any ambiguity as to Traumatic or Spontaneous - exclude 4. Should you include? 70 year old Frequently faller over past weeks : No definite date of fall. Collapsed with possible stroke or traumatic Subarachnoid haemorrhage 5. Should you include? 45 year old admitted to hospital on 20 th February 2015 with medical condition. Fell on Ward on 1 st March 2015 & sustained Fracture to skull Discharged on 10 th March 2015 Answer: Yes as injury is TARN eligible Date of Arrival & Date of incident should be the date the Trauma occurred in hospital (1 st March), not the original medical admission date.

Questions?