TNCS audit 2016

1. Injury Surveillance Data
2016
Trauma Nurse Coordination System
J.P.N. Apex Trauma Centre, AIIMS

2. Initial Triage ED
5.86%
23.43%
70.26%
0.43%
0.00%
10.00%
20.00%
30.00%
40.00%
50.00%
60.00%
70.00%
80.00%
RED YELLOW GREEN BROUGHT DEAD
n=66891
YEAR 2016
Footfall in Emergency Department 66891
Patients Included in Trauma Registry 18172

3. Gender Distribution
76.95%
23.04%
MALE
FEMALE
n=18172

4. Distribution as per the age of patient
0.58%
11.90%
14.42%
29.45%
18.28%
11.74%
6.65%
2.67%
4.25%
0.00%
5.00%
10.00%
15.00%
20.00%
25.00%
30.00%
35.00%
< 1 1 - 10 11-20 21-30 31-40 41-50 51-60 61-65 >65
(n=18172)

5. Broad Classification by Cause of Injury
48.02%
35.04%
15.12%
0.79% 0.61% 0.38%
0.00%
10.00%
20.00%
30.00%
40.00%
50.00%
60.00%
ROAD TRAFFIC
INJURIES
UNINTENTIONAL/
ACCIDENTAL
ASSAULT RAILWAY TRACK
INJURIES
INTENTIONAL SELF
HARM
NON TRAUMA
(n=18172)

6. Mode of Injuries in various age groups
RTI Unintentional Assault Non-Trauma Int. Self Harm Rail Track
< 01 14 88 2 2 0 0
1-10 442 1688 27 3 2 1
11-20 1336 756 482 4 23 21
21-30 3062 1113 1070 15 50 43
31-40 1788 829 625 14 30 36
41-50 1191 583 326 7 6 22
51-60 562 502 121 11 1 13
61-65 183 253 39 7 0 5
> 65 150 557 56 7 0 4
n = 18172

7. Mechanism of Injury
96.45%
17,527
1.37%
250
0.94%
172
0.67%
122
0.08%
15
0.39%
71
0.05%
10
0.02%
5
0.00%
20.00%
40.00%
60.00%
80.00%
100.00%
120.00%
BLUNT PENETRATING SSC DSC MIXED NON TRAUMA BURNS POISIONING
(n=18172)

8. Direct V/S Referral
Direct
85%
referred
15%
n=18172)

9. Referral Time
81.12%
18.87%
0.00%
10.00%
20.00%
30.00%
40.00%
50.00%
60.00%
70.00%
80.00%
90.00%
< 24 Hrs > 24 Hrs
n=2718

10. Outcome of Referrals
21.37%
19.35%
7.65%
20.30%
28.10%
0.40%
1.28% 0.73% 0.77%
(n=2718)
48.38%

11. Victims Brought By Person
0.34% 0.01%
2.39% 2.61%
0.04%
65.48%
0.15%
3.77%
23.31%
1.38% 0.46%
0.00%
10.00%
20.00%
30.00%
40.00%
50.00%
60.00%
70.00%
(n=18172)

12. Vehicles used to bring patients
0.09%
18
12.03%
2187
2.61%
475
30.95%
5625
27.63%
5022
23.23%
4222
1.17%
214
1.70%
310 0.39%
72
0.04%
8
0.10%
19
0.00%
5.00%
10.00%
15.00%
20.00%
25.00%
30.00%
35.00%
(n=18172)

13. Victims brought by PCR in all modes
57.98%
35.59%
4.42%
0.75% 1.04% 0.18%
0.00%
10.00%
20.00%
30.00%
40.00%
50.00%
60.00%
70.00%
RTI Assault Unintentional
Injury
Int. Self Harm Rail Track
Injury
Non-Trauma
(n=4222)

14. Victims brought by CATS in all modes
65.05%
10.52%
15.78%
0.84%
7.36%
0.42%
0.00%
10.00%
20.00%
30.00%
40.00%
50.00%
60.00%
70.00%
RTI Assault Unintentional
Injury
Int. Self Harm Rail Track
Injury
Non-Trauma
(n=475)

15. RTI Victims Brought By Person
0.56%
4.39% 3.54%
56.78%
0.18%
3.98%
28.13%
1.43% 0.97%
0.00%
10.00%
20.00%
30.00%
40.00%
50.00%
60.00%
Ambulance
Personnel
By Stander CATS Family &
Relative
Hospital
Staff
Known
Person
Police Self Who Hit The
Patient
n=8728

16. RTI Victims Brought By Vehicle
28.04%
26.97%
23.10%
15.45%
3.54%
1.38% 1.07%
0.24% 0.03% 0.03% 0.09%
0.00%
5.00%
10.00%
15.00%
20.00%
25.00%
30.00%
n=8728

17. Road Traffic Injuries
Who is Injured
74.16%
22.23%
3.59%
0.00%
10.00%
20.00%
30.00%
40.00%
50.00%
60.00%
70.00%
80.00%
IN/ON Vehicle Pedestrian Unknown
n=8728

18. Road Traffic Injuries
Victim’s Vehicle Involved
71.01%
8.97% 8.38%
6.53%
1.69% 1.65% 1.17% 0.26% 0.24% 0.04%
0.00%
10.00%
20.00%
30.00%
40.00%
50.00%
60.00%
70.00%
80.00%
Two
Wheeler
Auto Car Pedalcycle Bus Truck Pick Up
Truck
Animal
Drwan
Vehicle
Tractor Industrial
Vehicle
n=6473

19. 96.95%
58.23%
100.00%
3.04%
41.76%
0.00% 20.00% 40.00% 60.00% 80.00% 100.00% 120.00%
Driver,(n=3476)
Pillion (n=1087)
Unknown (n=34) MALE
FEMALE
n=4597
Road Traffic Injuries
Who is Injured while travelling on a Two Wheeler

20. Road Traffic Injuries
Helmet Usage by Status of Patient
0% 20% 40% 60% 80% 100%
PILLION,(n=1087)
Driver,(n=3476)
unknown,(n=34)
28.05%
55.29%
17.64%
71.94%
44.41%
82.35%
Helmet
No Helmet

21. Road Traffic Injuries
Helmet Usage by Gender of Patient
30.53%
51.07%
69.46%
48.92%
0.00% 20.00% 40.00% 60.00% 80.00% 100.00% 120.00%
Female,(n=273)
Male, (n=2172)
Helmet
No Helmet

22. Road Traffic Injuries
Disposition of Helmeted / Non-Helmeted
ADM Tr-Out Disc LAMA Absc BD ED Death
Male
Helmeted
(n=2062)
15.90% 21.24% 56.88% 0.48% 4.70% 0.58% 0.14%
Male
Non-
Helmeted
(n=1975)
22.58% 19.59% 50.32% 0.55% 4.35% 2.17% 0.40%
Female
Helmeted
(n=171)
9.35% 0.58% 70.17% NONE 6.43% 0.58% NONE
Female
Non-
Helmeted
(n=389)
16.96% 15.68% 61.95% NONE 4.62% 0.25% 0.51%

23. Road Traffic Injuries
Pedestrian Hit By Vehicle
38.12%
36.37%
7.77% 6.90%
3.91% 2.78% 2.26%
0.82% 0.82% 0.20%
(n=1941)

24. Unintentional cause of injuries
29.91%
26.53%
25.56%
5.93%
0.56%
0.25%
4.27%
1.64%
0.91%
0.83%
0.81%
0.45%
0.45%
0.31%
0.28%
0.15%
0.10%
0.07%
0.04%
0.86%
n=6369
88.75%

25. Railway Track Injuries
88.27%
11.72%
Brought Alive
Brough Dead
51.72
%
48.27
%
PASSANGER
TRESSPASSER
n=145

26. Assault
85.51%
7.71%
4.62% 1.81% 0.32%
n=2748
High Velocity Low Velocity
40.56
%
59.43
%
n=212Penetrating Injuries

27. Intentional Self Harm
Sharp Object Hanging Fire Arm Jumped From
Height
Lying infront
of Moving
Object
Poisioning Others
46.42%
32.14%
5.35% 5.35%
3.57% 3.57% 3.57%
n=112

28. Admissions From Emergency Department
Neurosurgery Trauma Surgery Orthopaedics
34.00%
44.34%
21.64%
n=3211

29. Final Disposition of all patients From Emergency
Department
Admission Tr-Out Discharge Abscond LAMA Brought
Dead
ED Death
17.67% 17.76%
57.39%
4.79%
0.40% 1.59% 0.37%
n=18172

30. ISS Based Outcome of Admitted Patients
73.80%
26.19%
0.00%
10.00%
20.00%
30.00%
40.00%
50.00%
60.00%
70.00%
80.00%
ISS <15 ISS>15
n=2550
0% 50% 100%
ISS <15 (n=1882)
ISS >15 (n=668)
92.29%
82.00%
7.70%
17.96%
Survivors
Deaths

31. Multiple Casualty Incidents 2016
• Total no. of incidents = 12
• Incidents where total no. of patient were 6 or >6 = 9
• Incidents description :
Assault = 02
R.T.I. = 08
Construction Site = 02
• 8 incidents happened within 15 km radius from T.C.
• 2 Incidents were happened outside Delhi (Noida & Merrut)
Contd……

32. Details of Patients Injured in MCI
SL No. Type Total Patients Red Yellow Green Black Admission Disch Tr-Out
1 RTI 6 1 4 1 Nil Nil 5 1
2 CS 12 0 0 12 0 0 12 0
3 RTI 13 3 10 0 0 4 7 2
4 RTI 7 0 5 0 2 2 3 0
5 RTI 5 1 2 1 1 1 3 0
6 RTI 6 0 4 2 0 1 5 0
7 ASLT 12 0 3 12 0 0 15 0
8 CS 5 0 5 0 0 1 4 0
9 RTI 12 11 0 0 1 6 5 0
10 ASLT 21 1 6 14 0 1 19 1
11 RTI 5 1 4 0 0 2 2 1
12 RTI 8 1 7 0 0 0 8 0

33. TNCS Team
Faculty In-charge : Prof. Amit Gupta
Suresh Chand Sangi
Tulsi Ram Gupta
Shallu Chauhan
Bincy Denny
Vipin Bihari Mishra
Rebecca
Mary Teenu
Preetha Francis
Sandhya Antony
Josmy Nibin
Jisha
Rakesh
Vishnu Kumar V
Ramchandran R
Robin
Anu Babu
Ashish Jhakal