The effectiveness of a statewide trauma call center in reducing time to definitive care for severely injured patients

Porter, Austin; Wyrick, Deidre L.; Bowman, Stephen M.; Recicar, John; Maxson, R. Todd

doi:10.1097/ta.0000000000000142

Cited by 17 publications

(5 citation statements)

References 9 publications

(5 reference statements)

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“…In comparison, transfer times for trauma patients utilizing the standard IFT process range from two hours to greater than four hours in some studies, though varying definitions of transport/ transfer time were used. 7,9,10,14 It is well-described in current literature that timely treatment at a TC, ideally via direct transport to a TC or secondarily via rapid transfer to a TC from a non-TC, results in reduced morbidity and mortality for trauma patients. 3,4,7,15,16 Though 911 re-triage is not a replacement for direct routing, it can minimize delays to definitive care for critically injured patients who arrive at a non-TC, with a median total transfer time from EMS notification to arrival at the TC of 21 minutes in this cohort.…”

Section: Discussionmentioning

confidence: 99%

Use of 911 for Rapid Re-Triage of Critical Trauma Patients

Toy

Kazan

Gausche‐Hill

et al. 2020

Prehosp. Disaster med.

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Objectives: The objective of this study was to evaluate the effectiveness of a 911 trauma re-triage protocol implemented at a new community hospital in a region with a high volume of trauma and frequent transports by private vehicle. Methods: This retrospective cohort study included all trauma patients ≥15 years old transferred via 911 trauma re-triage from a new community hospital over a 10-month period from August 2015 through April 2016. Criteria for 911 trauma re-triage were developed with input from local Emergency Medical Services (EMS) and trauma experts. An educational module, along with the criteria and implementation steps, was distributed to the emergency department (ED) personnel at the community hospital. Data were abstracted from the regional trauma registry, and the EMS patient care records were reviewed. Primary outcomes were: (1) median total transport time; and (2) proportion of patients who met the 911 re-triage criteria. Results: During the study period, 32 patients with traumatic injuries were transferred via 911 re-triage to the closest trauma center (TC). The median age of patients was 31 years (IQR 24-45 years) with 78% male and 66% suffering from a penetrating mechanism. The median prehospital provider scene time was 10 minutes (IQR 8-12 minutes) and transport time was seven minutes (IQR 6-9 minutes). Median total transport time was 17 minutes (IQR 15-20 minutes). Seventeen patients (53%) met 911 re-triage criteria as determined by study investigators. The most common criteria met was “penetrating injury to the head, neck, or torso” in 14 cases. Conclusion: This study demonstrated that 911 re-triage was a feasible strategy to expeditiously transfer critical trauma patients to a TC within a mature trauma system in an urban-suburban setting with a median total transport time of 17 minutes.

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Section: Discussionmentioning

confidence: 99%

Use of 911 for Rapid Re-Triage of Critical Trauma Patients

Toy

Kazan

Gausche‐Hill

et al. 2020

Prehosp. Disaster med.

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“…Porém, o encaminhamento dos casos às unidades assistenciais é quase sempre dificultado, sobretudo, pela falta de vagas em UTI para os pacientes graves, levando à manutenção do paciente por período superior ao recomendado no PA. Esta realidade ocasiona uma superlotação e, com isso, maior dificuldade de que uma assistência adequada e livre de riscos seja oferecida/disponibilizada aos pacientes. Tal situação não é encontrada em outros estudos internacionais, em que os pacientes permanecem por curtos períodos de tempo das salas de emergências, sendo transferidos para outras unidades com maior rapidez e fluxo garantido [10][11] .…”

Section: Discussionunclassified

Adesão à higiene de mãos entre profissionais de um serviço de pronto atendimento

Oliveira

Paula

Souza

et al. 2016

Rev. Med. (São Paulo)

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Objetivo: avaliar a taxa de adesão à higiene de mãos de uma equipe multiprofissional. Materiais e métodos: estudo transversal, realizado em uma unidade de pronto atendimento de um hospital universitário de Belo Horizonte-MG, entre maio e agosto de 2013, por meio de observação direta das equipes médicas e de enfermagem. As observações se basearam nos cinco momentos para higienização das mãos da Organização Mundial de Saúde, utilizando-se um instrumento estruturado. Os dados foram analisados no SPSS, realizando-se análise descritiva e univariada. Resultados: registraram-se 931 oportunidades de higienização das mãos, 88,9% entre os técnicos de enfermagem, 6,9% médicos, 3,7% enfermeiros e 0,5% para auxiliares de enfermagem, obtendo-se uma taxa de adesão global de 19,4%. A higienização simples com água e sabão foi mais utilizada pelos profissionais (47%). Conclusão: a taxa de adesão à higienização das mãos foi considerada baixa, observando-se a necessidade e treinamentos para melhoria da mesma.

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“…In Arkansas, providers utilize the Arkansas Trauma Communications Center (ATCC), which triages patients and directs where they should be transported within the system. 30 Before the ATCC was established in 2012, transfer requests were unregulated and unorganized because of the lack of a centralized system of communication and triage. Referring hospitals had to “go down the list” of facilities with availability to find one willing to accept the patient.…”

Section: Challenges and Solutions For Rural Traumamentioning

confidence: 99%