Caring for Our Patients With Major Trauma

Derriford Hospital Emergency Department
This department is situated on level 6 of Derriford hospital, to the right of the main entrance. The department is staffed with a mix of NHS and military personnel and as such there is a wealth of experience available to trauma patients.

Patients with major trauma are taken straight through into the resuscitation bay where they are seen by a team of doctors and nurses, led by a consultant. The appropriate specialists will be called as they are required.

For patients transferred to our Peninsula Trauma Trauma Centre from one of the Trauma Units, all of the necessary information and x-rays/scans is provided by the local Trauma Unit to the Trauma Centre.

Consultants
Mr P A Belsham
Mr D Alao
Dr D Boon
Dr A Hicks
Dr I Higginson
Dr Bruijns
Surgeon Commander A Smith
Surgeon Commander J Kehoe
Lt Colonel S Horne
Surgeon Commander D Henning

General Surgery
General surgery emergency services are provided by 14 consultants available within 30 minutes, 24 hours a day throughout the year. This service includes the sub-specialisations of colorectal surgery, hepatobiliary and pancreatic surgery, oesphagogastric surgery, urology and transplant surgery. Care is given on three specialist wards, Wolf, Stonehouse or Braunton with support from intensive care and an emergency theatre is available 24 hours throughout the year.

HPB/Pancreatic Consultants
Mr D Stell
Mr M Bowles
Dr S Aroori

Oesophago-gastric Consultants
Mr G Saunders
Dr T Wheatley

General Surgery Consultants
Surgeon Commander A Lambert
Mr J Akoh

Colorectal Consultants
Miss C Adams
Mr S Brundell
Mr M Coleman
Mr W Douie
Mr C Gandy
Mr K Hosie
Mr C Oppong

Plastic & Reconstructive Surgery
The Plastic Surgery Department at Derriford Hospital manages a broad range of trauma, receiving referrals from both the emergency department at Derriford and as tertiary referrals from other hospitals within the region. The department provides all hand trauma services, and is a designated Burn Facility for both adults and children within the southwest UK Burn Care Network. Complex lower limb trauma care and reconstruction is provided in conjunction with orthopaedic surgeons to nationally-set standards.

The majority of hand injuries are managed on a day-case basis. More complex trauma in adults is managed either on Critical Care or by specialist Plastic Surgery nurses on Lynher Ward. Children are treated within the Plym Unit and on Woodcock ward.

Burns and Plastics, Trauma Consultants:
Mr R Morris 
Mr A Fitton
Mr R Rickard 
Mr D Camp
Mr D Mackenzie 
Mr J Manushakian
Mr L Currie
 
Cardiothoracics
Cardiothoracic services are provided in the purpose built South West Cardiothoracic Centre within the Terence Lewis Building at Derriford Hospital. This state of the art centre opened in June 2007, and follows the success of the original heart surgical centre that opened in 1997, and which rapidly expanded to become a centre of excellence. Using the latest techniques and advanced technology, the Centre offers the full range of adult cardiac surgery other than transplantation. All surgeons are all members of the Society for Cardiothoracic Surgery in Great Britain and Ireland.

Cardiothoracic Surgeons   
Mr Allen
Mr Marchbank
Mr Lloyd
Mr Dalrymple-Hay
Mr Kuo
Mr Unsworth-White

Thoracic Surgeons
Mr Rahamim
Mr Awan

Neuroradiology
The Department of Neuroradiology provides specialist imaging to people in the peninsula as well as neuro-imaging to the South West Neurosurgical Centre. In collaboration with Mr Whitfield, consultant neurosurgeon, a specialist neurovascular clinic has been set up which sees patients with cranial and spinal vascular disease. Most cerebral aneurysms are now treated through the blood vessels via a small incision made in the groin. This involves packing an aneurysm with coils to prevent it rupturing. The department performs over 400 cerebral angiographic and neuro-embolisation procedures per year.

Diagnostic/Interventional Neuroradiologists
Dr W M Adams
Dr W Mukonoweshuro
Dr JO Jones

Neurosurgery
Neurosurgical services are provided through the Southwest Neurosurgical Centre. Both Neurological and Neurosurgical Critical Care services are provided on Pencarrow Ward and other specialist care is provided on Moorgate Ward.

Moorgate Ward has a team of specialist doctors, nurses and therapists who are able to provide a high level of care to all brain injured patients. The ward has its own dedicated therapy gym so that patients are able to make best use of their therapy sessions.
 
Neurosurgeons
Miss A Moore 
Mr P Whitfield
Mr L Pobereskin 
Mr Sudhaker
Mr J Palmer 
Mr P Fewings
Mr A Germon  
Mr Haden
 

Radiology
The radiology department provides X-ray, ultrasound, CT and MRI imaging to the rest of the Hospital. Both diagnostic and interventional imaging will be provided 24 hours a day for trauma cases. Trauma cases normally involve x-rays and CT with interventional radiology used to urgently stop bleeding. We have a total of 26 consultant radiologists including four military radiologists with recent deployed trauma experience.

Vascular Surgery
The Vascular Service provides Consultant Surgeon delivered care for patients within the peninsula. The multi-disciplinary team involved in injured patient care includes dedicated interventional radiologists. Surgeons treat patients from the whole spectrum of vascular injury including complex limb, torso and neck injuries. The hospital has an operating theatre devoted to the surgical management of these patients manned by expert theatre staff available 24 hours a day. Eight Vascular surgeons work as a team across the peninsula.

Vascular Surgeons
Mr Simon Ashley
Mr Jamie Barwell
Mr Harvey Chant
Mr Jonathan Davies
Mr Francis Dix
Mr Chris Parry
Mr Graham Riding
Mr Ken Woodburn

Trauma and Orthopaedic Surgery (Incl Pelvic and Acetabular)
The Trauma and Orthopaedic Service provides Consultant Surgeon delivered care for patients within the peninsula. The multi-disciplinary team involved in injured patient care includes dedicated occupational and physical therapists and experienced orthopaedic nurses working on specialist trauma wards. The internationally trained surgeons treat patients from the whole spectrum of injury including pelvic and other complex fractures. The hospital has an operating theatre devoted to the surgical management of these patients manned by expert theatre staff available 24 hours a day.

Trauma & Orthopaedic Surgeons 
Scott Adams   
Charles Gozzard
Helmy Fekry   
Huw David
Mark Brinsden   
Robert Jeffrey
Sue Fullilove   
David Stitson
Simon Coleridge   
Jon Keenan
Steven Smith
Ben Holroyd

Maxillo-Facial Surgery

Paediatric Care
Derriford Hospital is not a Paediatric Trauma Centre and as such does not provide the level of care that children with traumatic injuries may require. Usually children with Neurological and Burns Injuries will be transferred to Frenchay Hospital in Bristol with possible transfer to Bristol Children’s Hospital later on. Children will normally be looked after at their nearest Trauma Unit until the specialist Paediatric Transfer Team is able to collect them and take them to Bristol.

Penrose and Pencarrow Intensive Care Units
The main Intensive Care Unit moved into its new state of-the-art home when the Terrance Lewis building opened in 2007. The unit is divided into two parts with Penrose ward (General ICU) having a nominal 14 beds and Pencarrow ( Neuro ICU) having a nominal 10 beds – these are however used flexibly as demand requires.

When trauma patients are transferred to the Intensive Care Unit, they have their immediate care needs assessed, their condition stabilised, life saving treatments initiated and comfort needs addressed. In order to do this we may need to attach various tubes, machines and other necessary equipment to patients. This can take some time and this is quite normal. The care on the unit is provided by intensivists and specialist nursing and therapy staff.

Intensivists
Dr Rebecca Appleboam 
Dr Phill Gillen
Dr Robin Berry 
Dr Peter MacNaughton
Dr Stuart Dickson 
Dr Mark Sair
Dr Colin Ferguson 
Dr Elfyn Thomas
Dr Martyn West 
Dr Sam Waddy

Cardiac Critical Care
If patients are transferred to the Cardiac Critical Care Unit, it is because they have chest or heart injuries that require specialist care which can be provided by the staff on this unit. Torrington ward is part of the modern Southwest Cardiothoracic Centre which was set up in 2007 and the Intensive Care Unit has eight beds and the High Dependency Unit has six beds.

Patients admitted to the Cardiac critical care are managed by the cardiac intensivists in conjunction with the cardiac surgeons and nursed by specialist cardiothoracic nurses.  All the cardiac intensivists are members of the Faculty of Intensive Care Medicine (UK).

Cardiac Intensivists
Dr Jonathan Ambler
Dr Mark Bennett
Dr Chris Cummings
Dr Sergei Dudnikov
Dr Mo Jayarajah
Dr Nilofer Mahmood
Dr Peter Murphy
Dr Pete Robbins
Dr Maria Safar

Anaesthetics
Patients suffering trauma may require resuscitation, surgery and advanced diagnostic imaging. These procedures require general anaesthesia and may need advanced airway management and sophisticated monitoring & pain relief techniques . Anaesthesia for urgent and emergency cases is provided by over 50 consultants or independent specialists, assisted by a large complement of doctors undergoing specialty training, operating department practitioners, theatre and recovery staff.  Round the clock expertise is immediately available in anaesthesia for paediatrics, neurosurgery and acute pain. 

Trauma Nurse Co-ordinators
The Trauma Nurse Co-ordinators or TNC’s, are a small team of experienced nurses whose job is to act as a co-ordinator, on behalf of patients, for both the nursing and medical teams. This is to ensure that all of the treatments, investigations and therapies need for each person are carried out as efficiently and quickly as possible. It is also part of their role to ensure that when someone is ready to be transferred, whether to their local hospital or to another centre to commence rehabilitation, that this transfer is organised and happens as soon as appropriate. They will also provide a contact point for relatives so that if there are any issues that relatives wish to raise, they are more than happy to help.

Currently there are three Trauma Nurse Co-ordinators (TNC’s) with a fourth in the process of being appointed. Because Derriford Hospital is also a Ministry of Defence Hospital Unit we are very fortunate to have the skills of two military TNC’s who work alongside their NHS counterparts and bring a wealth of knowledge and experience with them. They are currently available between the hours of 7.30am and 3.30pm Mon – Fri.

Trauma nurse Co-ordinators
CPO Matt Rawlins, RGN
Sgt Gemma Westran, RGN
Sharon Warne, RGN