Many seriously injured, especially older women, brought to ill-prepared trauma centers

Every year around 4,500 people suffer serious injuries as a result of an accident. Around one-third of these patients, predominantly elderly women, are brought to a common general hospital instead of a trauma treatment center, the AD reported.

“Regional hospitals say they can still provide trauma care. But that attitude costs lives”, said Loek Leenen, head of the trauma department at UMC Utrecht.  Only four out of eleven trauma centers meet the standard of treating 240 trauma patients per year in order to be considered well-trained for the job, according to acute care network LNAZ.

Former Health Minister Els Borst decided already in 1999 that trauma patients should be brought to specialized hospitals. “It is crazy that 22 years after the establishment of trauma centers, we are still unable to transport patients to a hospital where they are equipped for the severity of their injury”, said Ernst Kuipers, the head of the LNAZ and the Erasmus Medical Center.

In general hospitals, trauma injuries are less likely to be treated effectively. “When patients are received in a regional hospital, with all due respect, but they will first receive the patient, then make a scan and then, call the neurosurgeon. The neurosurgeon and specialized radiologist are already prepared at a trauma which reduces the mortality risk”, Kuipers explained.

Part of the problem is that injury assessment in the field needs to improve. Brain injury, for example, can be hard to detect since the effects sometimes only appear later.

Still, particularly the injuries of older women are often overlooked and they are brought to a regular hospital. "Women more often have brittle bones and complain less," Leenen said.

The chair of the Dutch Association for Emergency Physicians (NVSHA), David Baden, said that another problem is that elderly patients, particularly women, find it difficult to indicate the origin of their physical pain.

Baden advocated for the use of more trauma helicopters in the Netherlands to bring patients to trauma centers as quickly as possible if these are located further away. “I think it’s absurd we don’t use trauma helicopters more often in the Netherlands. Even from 15 kilometers away it is faster with the helicopter.” 

Kuipers also said that hospital administrators should also check to see if patients are being brought to the right treatment facility. “If a hospital administers sees in one year that thirty serious trauma patients were treated, he must say: there should have been zero”, Kuipers said. “Good treatment in a trauma center can make all the difference: either you end up in a wheelchair or you are able to walk.”