Date post: | 29-Dec-2015 |
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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
Include Exclude (in isolation)
Skull fracture Scalp injuries
Traumatic haemorrhage Spontaneous haemorrhage (stroke, aneurysm )
Brain Contusion Loss of consciousness
Brain Laceration/penetration
Traumatic Brain swelling
Vascular injury
Nerve injury
Diffuse Axonal Injury (DAI)
FACIAL Injuries
Include Exclude (in isolation)Unstable fracture
(usually fixed in theatre)Skin injuries
Orbital Blow out fracture Closed/stable fracture/s (even if multiple)
Le fort fracture (I, II or III) All other injuries to eye
Pan-facial fracture All injuries to ear
Vascular injury
Nerve injury
Eye Avulsion
Traumatic Retinal detachment
Globe rupture
NECK Injuries
Include Exclude (in isolation)Vascular injury Skin injuries
Organ injury Nerve injury
Hyoid fracture
THORACIC Injuries
Include Exclude (in isolation)Vascular injury Skin injuries
Organ injury
Rib fracture/sFlail chest (unstable chest wall)
Haemothorax (blood in thorax)
Pneumothorax (air in thorax)
Haemomediastinum (blood in mediastinum)
Pneumomediastinum (air in mediastinum)
Sternum fracture
ABDOMINAL Injuries
Include Exclude (in isolation)Vascular injury Skin injuries
Organ injury (contusion, laceration, transection, avulsion,
perforation, rupture) Retroperitoneal haemorrhage
SPINAL Injuries
Include Exclude (in isolation)Vertebral fracture Spinal strain
(whiplash)
Vertebral dislocation Ligament
Disc injuryNerve root injury
Cord injury
FEMORAL Injuries
Include Exclude >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
Include Exclude >65 years old
Acetabulum fracture Single pubic rami fractureIschium, Sacrum, Coccyx or Ileum
Single pubic rami fracture <65Multiple 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 fractureVertical Shear fracture
Malgaigne fracture
UPPER LIMB or LOWER LEG InjuriesExcluding hands & feet
Include Exclude (even if multiple)Open fracture Closed fractures &/or dislocations of 1 limb
(even if multiple)
Total Crush injury All other Nerve injuries
Traumatic Amputation Muscle injuryMultiple limb fractures &/or dislocations Tendon injury
Transected vessels Ligament injurySciatic Nerve injury Sprain
HANDS & FEET Injuries
Include Exclude (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 InjuriesInclude Exclude (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
Include Exclude (in isolation)Electrocution injuries Bruises
Full thickness Frostbite Abrasions
Asphyxia (hanging or strangulation) Minor Skin lacerationsDrowning Minor 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 leftDied 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 oldFall over rug In hospital for 4 daysInjuries: Right # Neck of Femur & Right Radius #
3. Should you include?28 year oldCrushed 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 20th February 2015 with medical condition. Fell on Ward on 1st March 2015 & sustained Fracture to skullDischarged on 10th March 2015
Answer: Yes as injury is TARN eligible
Date of Arrival & Date of incident should be the date the Trauma occurred in hospital (1st March), not the original medical admission date.