title: The evolution of trauma services at Beaumont Hospital.
abstract: OBJECTIVE
  To review and examine the epidemiology, severity and management of trauma admissions at the national neurosurgical teaching hospital.
  
  
  METHODS
  An extensive audit of volume, type and severity of injury and the management requirements of the trauma population admitted to the hospital.
  
  
  RESULTS
  The vast majority of severely injured patients were referred from outside the catchment area of the hospital with only 26% being admitted directly through the Emergency Department. As a consequence, 73% of patients arrived out of normal working hours, which posed problems in providing skilled trauma specialists.
  
  
  CONCLUSIONS
  The management of patients with serious injury is complex. The large proportion of patients with critical injuries, some of whom were paediatric, highlighted the need for 24 h cover by senior trauma personnel and the provision of radiology and operating facilities to meet their needs. The inclusion of indicators of alterations in innate or adaptive immune responses may improve the predictive power of severity of injury scores.
authors.affiliation: Departments of Surgery, Royal College of Surgeons, Beaumont Hospital, Dublin 9, Ireland. maria.fitzgibbon@mailn.hse.ie
authors.forename: M C
authors.initials: MC
authors.lastname: Fitzgibbon
authors.forename: M
authors.initials: M
authors.lastname: Donnelly
authors.forename: J P
authors.initials: JP
authors.lastname: Phillips
authors.forename: P
authors.initials: P
authors.lastname: Murray
authors.forename: R
authors.initials: R
authors.lastname: Moran
authors.forename: D J
authors.initials: DJ
authors.lastname: Bouchier-Hayes
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D002648:Child; D019992:Databases as Topic; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D007494:Ireland / Q000453:epidemiology; D008297:Male; D008485:Medical Audit; D010865:Pilot Projects; D011446:Prospective Studies; D015599:Trauma Severity Indices; D014947:Wounds and Injuries / Q000453:epidemiology*