There is a call for a change in the way trauma services are provided in Ireland.
It comes as the National Office of Clinical Audit launches the Major Trauma Audit National Report 2016.
It focuses on major trauma, which is described a serious injury.
The report has found that 28% patients were transferred to another facility for ongoing trauma care as the necessary services were not available on the original site.
45% of patients with a severe head injury, meanwhile, did not receive care at a neurosurgical centre.
The audit also reveals the nature of trauma injuries in Ireland, with 'low falls’ - i.e. a fall of less than 2 metres - the leading cause of injury, at 51% of all major trauma patients.
47% of patients were injured in the home, while 31% had multiple injuries.
The average age of a major trauma patient is 55 years, while 40% of patients are 65 or older.
Dr Conor Deasy, Clinical Lead for Major Trauma Audit (MTA), said: “This report highlights the need for change. Patients with major trauma are not being assessed by trauma teams and senior clinicians on arrival to Emergency Departments.
"Key investigations and management are being delayed, only one-third of patients with head injuries requiring a CT scan received one within one-hour in line with international best practice standards."
He added: "We have seen the face of trauma change in recent years from younger males with high energy traumas to now, most commonly, older patients sustaining major trauma from falls at home.”