Summer tends to be the busiest season for the Nova Scotia Health Trauma Program (aka Trauma Nova Scotia) and that trend certainly continued in 2022.

A large amount of the work we've been focused on this summer included planning for our new Inpatient Trauma Consult Service (TC Service) which will be starting this fall at the QEII. We have been hiring physicians and RNs to work as Trauma Consultants (TCs) and Trauma Resource nurses, developing documentation and forms for the team to use, and meeting with stakeholders on inpatient units to introduce the concept of the team. We are very excited that the start date for the TC service is so close, and cannot wait to see the positive impact that this new service will have on inpatient trauma care. We will be closely tracking trauma patient outcomes and regularly sharing with stakeholders to ensure everyone is up to date on our progress.

Our Trauma Program Webinar Series will be starting up again in September after a summer layoff with Dr. Peter Brindley (University of Alberta) presenting on practical crisis management in trauma. Our program continues to provide outstanding education to physicians and interdisciplinary teams through our Advanced Trauma Life Support (ATLS) Courses, with more courses coming this fall and winter. We will also be hiring a new Education Consultant (now Trauma Clinical Leader) within the coming months, and we are working to further develop our Rural Trauma Team Development Courses (RTTDC) which will be offered provincially in 2023.

Building on our Nova Scotia Trauma Advisory Committee (NSTAC) work, we are also very excited to be arranging site visits throughout the province to gain a more frontline perspective on trauma resuscitation and post-resuscitative care at regional and community sites. It is essential that we have a clear picture of the present state of trauma care in Nova Scotia before we can start to improve it. We anticipate there will be many opportunities to standardize and improve care in all centers and we look forward to hearing from local experts.

There will be a lot of work ahead for our teams, and we’re very grateful to be able to work with all trauma clinicians and professionals in Nova Scotia and across the Maritimes who continue to impress with their dedication to trauma care.

Sincerely,

Dan Cashen, Director/Co-Lead

Robert Green, Senior Medical Director

NS Health Trauma Program            

Welcome to New TTLs

o  Mary-Lynn Watson: Dr. Watson has been an emergency medicine (EM) physician in Halifax for over 30 years, and has witnessed the evolution of our trauma system and patient care first hand. Dr. Watson embraces change (often a leader), and is excited to be a TTL.

o Sean Hurley: Dr. Hurley has experience in trauma care in multiple locations across Canada as part of his trauma fellowship with Trauma Nova Scotia (TNS). He is passionate about inpatient trauma care, and has been a lead contributor to multiple trauma care protocols in Nova Scotia. Dr. Hurley will be joining the trauma program as a TC and a TTL.

o Adam Harris: Dr. Harris completed a trauma fellowship with TNS as part of his EM. He joins the trauma program as a TC and TTL, and looks forward to building on the previous success of the RTTDC with educational outreach initiatives for interdisciplinary health teams across the province. 

o James Goud: Dr. Gould brings expertise and formal training in resuscitation, and is joining the trauma program as a TC and TTL. During his 2 years since completing his EM training, Dr. Gould has focused on improving resuscitations in the QEII ED, and will be a key resource in our program.

Special Thanks to Outgoing TTLs 

o Dave Petrie: Dr. Petrie has been a TTL and early system leader in Nova Scotia for over 20 years, while balancing his clinical activities in the QEII ED and as Department Head, Dalhousie Emergency Medicine. His expertise and important research in system design has been integral in positing our trauma system for the success that we have achieved.

o Sam Campbell: Dr. Campbell joined our trauma program in 2001, and has been a pillar of exemplary care. As a leader in the QEII ED, he has fostered the QEII ED Critical Care Paramedic Program, and partnerships between surgical services, the ED and EHS.

o Sean Christie: Dr. Christie has represented the Division of Neurosurgery as a TTL, and has been instrumental in the creation of the QEII C-spine clearance pathway. His leadership and advocacy for neurosurgical trauma care has benefitted many patients across NS and the Maritime provinces.

NSH Trauma Program provides educational opportunities to health care professionals in Nova Scotia and various opportunities in Prince Edward Island and New Brunswick. 

We continue to plan trauma education opportunities for 2022 and have started planning for 2023!  

Our Nova Scotia Trauma Registry (NSTR) captures data on all major traumas from hospitals across the province and from the NS Medical Examiner Service. 

The information gathered in the registry is used for surveillance, research, and to improve the quality of patient care.

For more information or to submit a data request, contact NSTR Coordinator Karen Ssebazza at nstrauma@nshealth.ca

Ongoing Research Activities

Unlike the United States, where TTLs are predominantly surgeons, TTLs in Canada are frequently physicians from non-surgical specialties. The NS Health Trauma Program collaborated with researchers across Canada to participate in a multicenter study led by Dr. John Taylor (Emergency Medicine, University of British Columbia) designed to determine if there is a difference in the outcomes of patients who receive care from a trauma team led by a surgeon versus care from a trauma team led by a non-surgeon. After adjusting for potential confounding factors, there was no difference in in-hospital mortality for patients treated by a surgeon or non-surgeon TTL. The study is currently under review with the Annals of Emergency Medicine.

Several ongoing research studies focus on the major trauma population of Nova Scotia and include:

• Investigations on traumatic cardiac arrest (led by Dr. Rob Green, NSH Trauma Program)
• Burn-related traumatic injury (led by Dr. James Nunn, Emergency Medicine, Dalhousie University)
• Pediatric major trauma (led by Dr. Jason Emsley, Pediatric Emergency Medicine, IWK Health Centre)
• ATV-related trauma (led by Dr. Robert Abraham, Diagnostic Radiology, Dalhousie University)
• Comparison of rural versus urban trauma mortality (led by Dr. Tyler Johnston, Emergency Medicine, NS Health)

In addition, upcoming studies are planned to evaluate the availability of trauma-related resources, equipment and staffing at regional and community hospitals in Nova Scotia, and to better understand the definitions for sex, gender, race, and ethnicity used by trauma registries across Canada.

We are also planning studies to evaluate the outcomes of trauma patients admitted to the QEII following implementation of the new inpatient trauma consult service to determine whether healthcare providers and patients/families are satisfied with the new consult service, and to assess whether self-reported levels of burnout decrease among TTLs and nurses after the consult service is implemented. 

Heal-NS Research Program

In collaboration with Dalhousie University medical students through the Research In Medicine (RIM) Program, we examined the epidemiology of gunshot wound trauma in Nova Scotia between 2001 and 2020. Using data collected from the Nova Scotia Trauma Registry and the Nova Scotia Medical Examiner Service, we found that trauma patients who sustained firearm-related injuries were predominantly male and that most injuries were self-inflicted among middle-aged to older patients. Younger patients tended to be victims of homicide or assault and were more likely to survive their injuries. The study has been accepted for publication in Injury.

Later this year, Heal-NS is planning to survey paramedics, nurses, physicians and other healthcare professionals across Nova Scotia regarding their opinions and personal experiences with workplace violence in the healthcare setting.