How you approach to the multiply injured patient from their arrival in the emergency department will have a huge impact on their outcome, whether they live or die and what level of functionality they will have into the future. All multiply injured patients should be cared for by a trauma team with a trauma team leader who is experienced in the management of major trauma.
Experience from other countries has shown that multiply injured patients who are cared for in an integrated trauma system have much better outcomes that those who are not.
In Ireland we are currently in the middle of implementing an integrated trauma system that will consist of 2 trauma networks. These networks will consist of one major trauma centre each supported by a number of trauma units. Most importantly there will be a whole system approach to trauma driving improvements in patient care from their initial contact with first responders right through to discharge from rehabilitation services.