Only 8% of people with life-threatening injuries are met by a trauma team when they arrive at Emergency Departments.
The Major Trauma Audit National Report for 2016 assessed over four thousand patient's treatment journeys.
The leading cause of injury is low falls affecting everyone in two cases of all major trauma patients and 77% of patients over 65.
Dr. Conor Deasy, Clinical Lead for MTA (Major Trauma Audit) says the findings prove we need to reform the system for treating seriously injured patients.
"The case for change is really clear from this data," said Dr Deasy.
"We need an inclusive trauma system where certain hospitals are designated as major trauma centres and that there would be relatively few of those and then other hospitals would be designated as trauma units.
"We would discontinue bringing patients to hospitals that aren't able to provide the services that those patients need."