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Critical Care, Trauma and Perioperative Medicine

Theme leader: Professor Paul Myles, The Alfred

Monash Partners houses the largest trauma service in Australia. It operates as one of three specialist trauma hospitals in the Victorian Trauma System, which is recognised as an international exemplar in trauma care.

The services are predominantly located at Alfred Health, but with links to Epworth (for rehabilitation services), and Monash Health.

Monash Partners provides 20% of Victoria’s critical care beds and nearly one third of state intensive care unit (ICU beds). There are 45 ICU beds at Alfred Health, 31 at Monash Health, 31 at Epworth across three sites (with a new 26-bed facility due in 2016) and 12 beds at Cabrini.

As one of Australia’s top performing trauma and critical care services, the team at Alfred Health has delivered risk-adjusted improvements in trauma mortality of over 50% and reduced trauma disability, using an integrated approach to improving outcomes through evidence.

Models of care developed by the team have been adopted internationally. They include:

  • Hypothermia in cardiac arrest
  • Centralisation of cardiac arrest victim destination
  • Continued resuscitation of patients in cardiac arrest to hospital
  • Pre-hospital rapid sequence intubation
  • Withdrawal of albumin resuscitation for head injury patients
  • A global re-evaluation of decompressive craniotomy for severe traumatic brain injury.

Future Goals:

1.     Leverage Alfred Health’s ICU initiated extracorporeal membrane oxygenation (ECMO) Service into a research network using the international ECMO registry (ELSO)

2.     Professor Russell Gruen at the National Trauma Research Institute (NTRI), along with Australian and Indian Governments will work together to improve trauma systems in a specialist trauma hospital in India

3.    Develop perioperative medicine guidelines for endpoint definitions in large clinical trials; e.g. organ injury/failure and disability-free survival.