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Objectives: Advanced Trauma Life Support (ATLS) has been shown to improve outcomes related to trauma resuscitation; however, omissions from this protocol persist. The objective of this study was to evaluate the effect of a trauma resuscitation checklist on performance of ATLS tasks.Methods: Video recordings of resuscitations of children sustaining blunt or penetrating injuries at a Level I pediatric trauma center were reviewed for completion and timeliness of ATLS primary and secondary survey tasks, with and without checklist use. Patient and resuscitation characteristics were obtained from the trauma registry. Data were collected during two 4-month periods before (n = 222) and after (n = 213) checklist implementation. The checklist contained 50 items and included four sections: prearrival, primary survey, secondary survey, and departure plan.Results: Five primary survey ATLS tasks (cervical spine immobilization, oxygen administration, palpating pulses, assessing neurologic status, and exposing the patient) and nine secondary survey ATLS tasks were performed more frequently (p ≤ 0.01 for all) and vital sign measurements were obtained faster (p ≤ 0.01 for all) after the checklist was implemented. When controlling for patient and event-specific characteristics, primary and secondary survey tasks overall were more likely to be completed (odds ratio [OR] = 2.66, primary survey; OR = 2.47, secondary survey; p < 0.001 for both) and primary survey tasks were performed faster (p < 0.001) after the checklist was implemented.Conclusions: Implementation of a trauma checklist was associated with greater ATLS task performance and with increased frequency and speed of primary and secondary survey task completion.

Implementing a checklist during simulated pediatric trauma resuscitation improves adherence to the ATLS protocol without increasing the workload of trauma team members.

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Resuscitation task completion varies by team size, with a nonlinear association between number of team members and completed tasks. Management of team size during high-acuity activations, those without prior notification, and those in which the patient has a penetrating injury may help optimize performance.

We evaluated passive radio-frequency identification (RFID) technology for detecting the use of objects and related activities during trauma resuscitation. Our system consisted of RFID tags and antennas, optimally placed for object detection, as well as algorithms for processing the RFID data to infer object use. To evaluate our approach, we tagged 81 objects in the resuscitation room and recorded RFID signal strength during 32 simulated resuscitations performed by trauma teams. We then analyzed RFID data to identify cues for recognizing resuscitation activities. Using these cues, we extracted descriptive features and applied machine-learning techniques to monitor interactions with objects. Our results show that an instance of a used object can be detected with accuracy rates greater than 90 percent in a crowded and fast-paced medical setting using off-the-shelf RFID equipment, and the time and duration of use can be identified with up to 83 percent accuracy. Our results also offer insights into the limitations of passive RFID and areas in which it needs to be complemented with other sensing technologies.

Prognostic study, level II.