Posted on June 2, 2008

Surgeon: One in Three of Trauma Patients Has Been Knifed

Justin Davenport and Anna Davis, This Is London, June 2, 2008

Knife violence in London is now running as high as gun warfare in some US cities, it is claimed today.

One of Britain’s leading trauma surgeons has told how one in three of his trauma patients is now a stabbing victim.

Karim Brohi, a consultant surgeon at the Royal London Hospital, said the proportion of injuries from knives and guns was now on a level with—if not greater than—cities such as Los Angeles or Chicago.

He described how, on occasions, the wards in his hospital resembled “a war zone” with some patients being treated for their second or third knife wound.

And—in a letter to the Evening Standard—Mr Brohi, along with two senior trauma medics, called for more prevention strategies to solve the underlying causes of knife crime.

He said there was a real “potential” for surgeons and doctors to help in the fight against crime through a variety of schemes—such as doctors visiting schools to talk about knife injuries.

Mr Brohi spoke out as an Evening Standard survey showed how casualty wards across the capital were bearing the brunt of the rise in knife crime and treating hundreds of victims each year.

A snapshot survey of wards reveals at least 424 knife victims have been treated in hospital for stab wounds so far this year, 227 of which were serious cases. The true number of victims is even higher because each hospital records cases of stabbings in different ways.

Some major trauma hospitals, such as the Royal London, show significant increases in the number of people being treated for major stab wounds.

Surgeons there have dealt with 100 major stabbings so far this year, compared to 77 in the same period last year.

Mr Brohi, one of the country’s experts in dealing with knife and gunshot injuries, said the number of people being treated for knife injuries was rising almost “month on month”.

His letter to the Standard was written along with two leading members of London’s medical profession, the Royal London’s surgical registrar Thomas Konig and Dr Anne Weaver, the lead clinician for the capital’s air ambulance service.

The medics say: “We have already seen 100 major stabbings at The Royal London Hospital alone this year. This figure does not include minor cuts and lacerations that are not life threatening and are seen on a daily basis. In 2007 we saw 71 patients in the same period and 185 patients in the whole year.

“The Helicopter Emergency Medical Service provides London-wide pre-hospital care and patients are treated at various hospitals across London and they see about 30 per cent of the major stabbings that occur.

“So far this year they have attended 121 patients with a stabbing injury, 19 of whom have died on the scene. They have performed open heart surgery on 10 patients on the streets of London this year alone.

“The number of stabbings in London is unfortunately beginning to match some inner city areas of the United States.

“The dramatic rise in serious injury from people carrying knives is undoubtedly having an impact on the hospitals treating these injuries. ”

The trauma experts say that underlying-social issues are behind knife crime and more needs to be done to develop prevention strategies alongside specialist trauma care. The letter states: “There is potential to reduce crime from our side if we could understand behaviour and liaise with victims and potential perpetrators. With a system that encompasses both treatment and injury prevention tactics we may go some way to improving outcome and decrease the level of violence that we are currently seeing across our city.”

Mr Brohi said one option could involve reformed gang members talking to stab victims in hospital in an effort to get them to mend their ways. He also gave details of how the rate of stabbings in the capital is matching American rates. At the Royal London last year about 23 per cent of its trauma workload involved penetrating wounds—stab or gunshot wounds—but last month this figure had risen to 30 per cent.

In the United States, surgeons at hospitals in cities such as Los Angeles, Detroit and Chicago treated an average of between 25 to 30 per cent of penetrative injuries. Only in some inner city boroughs such as Brooklyn in New York was the rate higher.

Mr Brohi pointed out that in the States the majority of the wounds were caused by gunshots, while in Britain the majority were knife injuries.

He described how surgeons often felt helpless in trying to deal with the underlying problems of knife culture.

He said: “When you get as many young people in who have been stabbed, walking around the wards sometimes feels almost like being in a war zone.

“It feels unpleasant, it is fairly depressing. Some are gang members, some are innocent victims, some are not in gangs but resort to knife crime to resolve really small disputes. The ages are getting younger.”

He went on: “We are a lot more than just surgeons. We have rehabilitation roles too. If you are involved in treating Aids or TB then you have a moral duty to be involved in preventing these diseases as well as treating them.

“It is our duty as health care workers to reduce the problem that is out there. That may mean working in schools helping educate kids about the consequences of their actions or it might involve bringing ex-gang members into hospitals to talk to people who are victims of violence.

“We have people coming in who are on their second or third stabbing and of course they may be likely to go out and stab someone.

“Somehow you have to break this cycle of young people feeling the need to carry a knife. We have tried to engage with community leaders but there is very little funding to employ people to do this.”