Rethinking the tiered trauma team response: A case‐series study in a regional trauma centre Article Swipe
Kate Curtis
,
Benjamin Clark
,
Mary Lam
,
Ryan Huckle
,
Geoffrey Melville
,
Simon Binks
,
Ms Wende Ryan
,
Trevor Gardner
,
Ms Brooke Parsons
,
Bruce Ashford
·
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.1111/1742-6723.14399
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.1111/1742-6723.14399
Objective To reduce perceived unnecessary resource use, we modified our tiered trauma response. If a patient was not physiologically compromised, surgical registrar attendance was not mandated. We investigated the effect of this change on missed injury, unplanned representation to ED, diagnostic imaging rates and staff satisfaction. Methods A retrospective case series study assessing the 3‐month period before and after the intervention was conducted. Logistic regression analyses were used to examine the association between ordering of computerised tomography (CT) and ED length of stay (LOS), injury severity (ISS), age, surgical review and admission. A staff survey was conducted to investigate staff perceptions of the practice change. Free text data were analysed using inductive content analysis. Results There were 105 patients in the control and 166 in the intervention group and their mean (SD) ISS was the same (ISS [SD] = 4 [±4] [ P = 0.608]). A higher proportion of the control group were admitted (56.3% vs 42.2% [ P = 0.032]) and they had a shorter ED LOS (274 min [202–456] vs 326 min [225–560], P = 0.044). The rate of missed injury was unchanged. A surgical review resulted in a 26‐fold increase in receipt of a whole‐body CT scan (odds ratio = 26.89, 95% confidence interval = 3.31–218.17). Just over half of survey respondents felt the change was safe (54.4%), and more surgical (90%) than ED staff (69%) reported the change as positive. Conclusion The removal of the surgical registrar from the initial trauma standby response did not result in any adverse events, reduced admissions, pathology and imaging, but resulted in an increased ED LOS and time to surgical review.
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Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1111/1742-6723.14399
- https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/1742-6723.14399
- OA Status
- hybrid
- Cited By
- 2
- References
- 27
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4392560684
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4392560684Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.1111/1742-6723.14399Digital Object Identifier
- Title
-
Rethinking the tiered trauma team response: A case‐series study in a regional trauma centreWork title
- Type
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articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2024Year of publication
- Publication date
-
2024-03-07Full publication date if available
- Authors
-
Kate Curtis, Benjamin Clark, Mary Lam, Ryan Huckle, Geoffrey Melville, Simon Binks, Ms Wende Ryan, Trevor Gardner, Ms Brooke Parsons, Bruce AshfordList of authors in order
- Landing page
-
https://doi.org/10.1111/1742-6723.14399Publisher landing page
- PDF URL
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https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/1742-6723.14399Direct link to full text PDF
- Open access
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YesWhether a free full text is available
- OA status
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hybridOpen access status per OpenAlex
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https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/1742-6723.14399Direct OA link when available
- Concepts
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Medicine, Trauma center, Odds ratio, Confidence interval, Logistic regression, Emergency medicine, Emergency department, Attendance, Injury Severity Score, Retrospective cohort study, Surgery, Injury prevention, Internal medicine, Poison control, Nursing, Economics, Economic growthTop concepts (fields/topics) attached by OpenAlex
- Cited by
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2Total citation count in OpenAlex
- Citations by year (recent)
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2025: 1, 2024: 1Per-year citation counts (last 5 years)
- References (count)
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27Number of works referenced by this work
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10Other works algorithmically related by OpenAlex
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| primary_location.raw_source_name | Emergency Medicine Australasia |
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| publication_date | 2024-03-07 |
| publication_year | 2024 |
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