Extract from ABC News
In the bustling hallway of a trauma ward, Kate Martin flips the pages closed on a patient's file after a quick consultation with her team.
"Ok, fabulous, moving along, cracking on."
She leads her colleagues at pace around the ward of the Royal Melbourne Hospital on their morning rounds.
The trauma surgeon grabs a squirt of sanitiser and is rubbing it into her hands as she moves on to the next patient.
"Knock, knock," she jokingly calls out while moving back the curtain around the bed.
There's a young Argentine man lying in the bed.
"An unrestrained passenger in a high-speed motor vehicle crash," a medico opposite Dr Martin begins, before detailing his injuries and hospital stay so far.
Road trauma causes a "huge chunk" of the cases Dr Martin treats, and she thinks it's often "under acknowledged".
"We focus on the death toll but behind all of those deaths, is a huge number of patients that are injured — they survive, but they've got life changing injuries."
No national statistics on the number of injuries in 2023
2023 was the deadliest year on Australia's roads in more than five years.
Victoria recorded its highest fatality rate in 15 years and South Australia saw a more than 60 per cent increase compared to the year before.
The Royal Australasian College of Surgeons has said the increase in deaths painted an "ominous picture", particularly in regard to a national strategy to aim for zero deaths and serious injuries by 2050.
In the 12 months to November, 1,253 people died. The total number of people killed on Australian roads in 2023 will be released on Monday.
But there are currently no national statistics on how many people were seriously injured in 2023.
The peak body for Australia's road transport and traffic agencies, Austroads, has said robust national data about injuries has been a "crucial information gap in the work to reduce road trauma in Australia".
The Australian Institute of Health and Welfare will release a report on injuries for the 2022-2023 financial year in the middle of this year, but there are variations in how data is collected.
Each state and territory is responsible for collecting its own figures, but Austroads said "inconsistencies" in the way they "measure crashes and injuries make it difficult to study how and why crashes occur, where they occur, the injuries they cause and how jurisdictions can best prevent them".
The Australia New Zealand Trauma Registry also releases injury data on the financial year. Its 2021-2022 report had data from 33 major hospitals, and said it was working to get more to contribute, with a particular focus on regional and remote communities.
Funding for the registry was the number one recommendation from the Road Safety Senate Committee in 2016 and it said it had "7 years of quality Australian data".
The latest report said while there have been differences in how data is collected between states, there is "a growing consensus on collection and standardisation".
Bicycles, motorbikes and cars: the patients on Dr Martin's roster
"I will gently sit you up in a tick, just to listen to the back of your lungs," Dr Martin explains to the young Argentine as she grabs a stethoscope from a colleague.
"I'll work around you, you stay nice and still."
The man's name is Ezequiel Ignacio Arauso Avalos, and he groans as he is shifted up.
Dr Martin is concerned about his pain.
"We haven't had a chest X-ray in three or four days, we should probably get another one, just to be sure."
Mr Avalos has broken ribs, a broken coccyx, fractures in his spine, and possible damage to his shoulder.
He is visiting Australia on a working holiday and had been driving back to a farm in regional Victoria when his friend lost control of the car.
"I remember when we start losing control, the car start rotating, after that I just remember being outside of the car, looking at the sky and just trying to stay still and breath as calm as possible," he says.
"I remember the helicopters coming to pick us up and after that I don't recall anything."
He was in a coma for the first few days in hospital.
"Do you know how much time will I stay here?" he asks Dr Martin.
"Probably a couple more days with us, definitely want to get your pain under a bit better control, and then try to get you to rehab," she replies.
The medical team says he wasn't wearing a seatbelt. Mr Avalos says he was and isn't sure what happened to it.
In the bed next to Mr Avalos is Lachie Reid, who was hit by a car while riding his bike to work.
He has a broken arm, fractured spine, and his voice is gravelly. Dr Martin examines his neck.
"You didn't have any bruises on your neck did you?" she asks.
"Not that I'm aware of," he answers.
She orders an internal check of his throat but says he should still be okay to leave hospital that afternoon. Mr Reid is looking at six weeks off work.
The team continue through the ward, moving in and out of rooms. There's another patient who Dr Martin says "wrapped his motorbike around a pole".
"We've got great strong pulses in that foot," one of Dr Martin's team says as she examines Taylor Codd's broken leg. He also has two broken wrists.
People move the pillow under his injured leg to make him more comfortable as they continue the examination.
"Up and down for me," one says.
"Can you push now? Push down against me?"
Dr Martin is happy with how Mr Codd is recovering after a surgery the day before to put rods into his injured limbs.
She comments to a colleague as they exit: "He's almost rehab ready."
'Breakthrough' pilot to collect injuries data
Austroads has recently released results from a pilot program to collect data about road injuries, which it has lauded as a "breakthrough".
It compiled information from hospitals and police from every jurisdiction except Western Australia, for 2008 to 2017.
It said it is the first time "data on this scale has been collected at a national level" and shows that national road crash injury data "is possible".
The report outlined issues it had obtaining the data, but said the way those issues were dealt with provided "a basis for the development of a national register of serious road injuries".
The research is ongoing, with the next immediate focus on incorporating WA.
"You can't improve things if you can't measure what you're doing, so it's critically important that we have high quality statistics and information," Professor Steve Robson, the president of the Australian Medical Association (AMA) said.
The AMA has backed a recent campaign from the Australian Automobile Association calling for road funding to be linked to greater data transparency.
The Royal Melbourne Hospital has seen an increase in road trauma patients in the past two years.
In 2022 there were 1,606 patients and in the year to November it had 1,353, with numbers increasing since a dip during COVID-19 lockdowns.
The ABC approached several major trauma hospitals from around Australia asking for similar data.
The Royal Adelaide Hospital had 1,091 patients with serious injuries from road trauma in 2023, 187 more than the previous year, and the highest number in six years.
The Royal Darwin Hospital and Palmerston Regional Hospital, which is also in the city, had 596 up to September of last year. The number for the full year of 2022 was 684.
The Tasmanian government publishes serious road injury data but is yet to release figures for last year. In 2022, 268 people were injured , which was higher than the year before, but below the 10-year average of 271.
Victoria's Transport Accident Commission had 2,917 hospitalisation claims filed in the first six months of 2023. There were 5,289 for the full year of 2022.
The Canberra Hospital said patients who present to its emergency department are categorised on injury, not how they received it. Queensland Health said the same for its hospitals.
New South Wales Health pointed to its latest publicly available data, which was from 2020-2021.
Other hospitals said they were unable to supply the information or didn't respond within deadline.
The hospitals contacted by the ABC do contribute to the Australia New Zealand Trauma Registry. Its report from 2021-2022 found transport was the biggest cause of injuries, accounting for almost 45 per cent.
'We are only human': In the ICU the phone is always ringing
In the ward below where Dr Martin is working, the nurse in charge of the Intensive Care Unit is speaking to a colleague when she's interrupted by the mobile in her pocket ringing.
"ICU access, Natalie speaking … Yep … Are they intubated; do you know?"
She pauses for the answer.
"You guys will obviously meet them on the helipad, and then we'll just receive them in ICU."
The phone is how everyone in the hospital reaches the unit and it rings "hundreds of times throughout the day".
"We are a 42 bed ICU, and the unit is busy at the best of times, there is a huge amount of road trauma in our unit," she says.
"We are only human. We love what we do, but it does take a toll on us.
"I think the most heartbreaking thing for us is the families. A lot of families sit here and they say to us, 'If only they didn't do that. If only they called me. If only they didn't take that extra drink'."
Within 20 minutes a helicopter is landing on the roof. Two Air Ambulance officers push an unconscious woman into the ward.
Down another hallway Yasmine Ali Abdelhamid, who oversees the unit, checks on a man recovering from a motorbike accident.
The man will be heading into surgery today.
"Do you know if they're just fixing the pelvis, or if they'll be fixing his ribs as well today?" Dr Ali Abdelhamid asks the nurse.
"They are going to do his ribs as well; I think the orthopaedic team are just going to go into theatre and try to do as much as they can."
Dr Ali Abdelhamid takes a stethoscope and checks the man's heartbeat and breathing.
She says the increase in road trauma since the easing of COVID-19 lockdowns has been significant.
"Obviously it's extremely tragic when someone loses their life unnecessarily on the roads, but what we see here in the hospital, in the Intensive Care Unit, are the patients who are living with the complications of their trauma," she says.
Improving patients lives after road trauma
Many road trauma patients will spend months in rehabilitation after leaving the hospital.
"We know that a percentage of these people will go on to develop chronic pain or otherwise have difficulty getting their lives back on track," Alison Sim from the University of Sydney said.
How well people will recover from a road injury can be predicted within days, and an early intervention program she has been working on has shown promising signs of being able to improve patient outcomes.
"An early intervention program is designed to be able to catch those people who may have that poor outcome and provide that higher level of support," the doctoral candidate said.
The research team received a grant from Victoria's Transport Accident Commission to run a small trail of the program, using telehealth sessions to provide support on pain management and assistance with claims management.
It's hoped a bigger trial will be held in the state soon.
"We're really pleased with the results and hope to be able to roll it out and offer it more widely," she said.
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