Accidents and injuries

Serious injuries can occur as a result of incidents such as car accidents, falls from high places, industrial and farming accidents, or assaults. Major physical trauma is the term used to describe serious or complex injuries caused by an external force – for example, during an accident or an assault.

Major trauma is a significant health issue in Australia. In Victoria, it is the leading cause of death in people aged one to 44 years. For every death, there are 31 hospital admissions and 144 hospital emergency department visits.

The impact on the injured person, their family and friends, and the community is enormous. The treatment of major trauma is specialised and requires the care of a team of trauma professionals.

Major trauma services in Victoria
In Victoria, people who experience major trauma are usually treated at a Major Trauma Service. Medical research indicates that people with severe injuries generally have better outcomes when treated at a hospital that matches the level of trauma service with individual patient needs.

The major trauma services in Victoria are The Alfred and the Royal Melbourne Hospitals for adults, and the Royal Children’s Hospital for infants, children and adolescents. Although the injury may have happened close to a smaller, less specialised hospital, you may be taken by road ambulance, helicopter or plane to one of these three specialist trauma services.

A number of other hospitals provide specialised treatment services to major trauma patients. These include Austin Health, which has a statewide spinal service providing treatment and rehabilitation for people with spinal injuries, and St Vincent’s Hospital, which provides microsurgical services for some major trauma patients (such as the reattachment or repair of damaged limbs and other body parts).

Initial hospital treatment
If you have a major trauma, initial hospital treatment may include:

• Emergency department – for assessment and immediate stabilisation of your injuries.
• Radiology – for x-rays to determine the extent of your injuries. These tests may be repeated during your hospital stay to determine how well your injuries are healing.
• Operating theatre – for surgery on any life-threatening injuries. This may be followed by other operations, particularly if you have multiple injuries.
• Intensive care unit – if necessary, you may need life support or may just need to be closely monitored.
• Trauma or general ward – until your injuries are stable enough for you to go home, or go to another hospital or rehabilitation centre for further treatment.
• Other hospital departments – you (and your family or support people) will have contact with numerous medical, nursing and allied health staff during your stay in hospital.

• Pain – any injury is painful, but pain is experienced differently by different people. Although pain and discomfort are common in major trauma, they can be well controlled. It is important that you report your pain to staff so that it can be managed correctly. Pain management is a priority in trauma care. Hospital staff and pain teams will monitor your pain continuously and give you the appropriate pain relief medication.
• Surgery – some injuries are managed without surgery, while others may require multiple operations over a considerable length of time. The treating doctor or surgeon will talk with you and your family about the planned treatment during your stay in hospital. You may need to return to the operating room a number of times, especially for repair of injuries involving broken bones or large cuts.
• Movement – major trauma affects your ability to move and do many things for yourself. Some people need help with feeding, washing and going to the toilet. Hospital staff are used to helping with these things and do so every day, so there is no need to be embarrassed. A physiotherapist may visit you during your hospital stay to help with normal daily activities and exercises.
• Wounds, swelling and scars – when your body is injured, it undergoes a healing process. Swelling is a normal part of this process. The swelling can be severe in the first couple of days, particularly if your face is injured. It is important to know that this swelling does go down in time. Scars are inevitable when your skin has been cut. They may be quite visible for the first couple of weeks, but will eventually settle down and fade.

• Be aware that this is an extremely stressful time for you and your family or friends.
• Be active in finding support and ways to cope with this stress.
• Make sure that there are plenty of opportunities for communication within the family.
• Ask the hospital staff what to expect during the recovery period.
• Realise that healing after a major trauma is a slow process and may take months.
• Keep a journal – this helps many people who experience major trauma. Some also like to take photographs.
• Hospital staff can help you and your family or support people through this tough time.

• In an emergency, always call triple zero (000) for an ambulance
• To report serious workplace emergencies (24 hours), call the Victorian WorkCover Authority Emergency Response Line Tel. 132 360
• Your doctor
• Hospital emergency department
• Hospital social worker
• Road Trauma Support Helpline Tel. 1300 367 797

• Major trauma is the term used to describe serious or complex injuries caused by an external force. These may occur as a result of incidents such as car accidents, falls from high places, industrial and farming accidents, or assaults.
• In Victoria, major trauma is the leading cause of death in people aged one to 44 years.
• In Victoria, people who experience major trauma are usually treated at a Major Trauma Service.
• Major trauma is sudden and unexpected. This can be difficult for the injured person and their family or friends to deal with.

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