1. Association Between Prearrival Notification Time and Advanced Trauma Life Support Protocol Adherence.
- Author
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Ahmed OZ, Yang S, Farneth RA, Sarcevic A, Marsic I, and Burd RS
- Subjects
- Adolescent, Advanced Trauma Life Support Care statistics & numerical data, Child, Child, Preschool, Communication, District of Columbia, Female, Hospitals, Pediatric, Humans, Infant, Male, Patient Care Team standards, Patient Care Team statistics & numerical data, Practice Guidelines as Topic, Quality Improvement, Time Factors, Trauma Centers standards, Trauma Centers statistics & numerical data, Trauma Severity Indices, Triage organization & administration, Triage standards, Triage statistics & numerical data, Video Recording, Wounds and Injuries diagnosis, Advanced Trauma Life Support Care standards, Guideline Adherence statistics & numerical data, Patient Care Team organization & administration, Trauma Centers organization & administration, Wounds and Injuries therapy
- Abstract
Background: Prearrival notification of injured patients facilitates preparation of personnel, equipment, and other resources needed for trauma evaluation and treatment. Our purpose was to determine the impact of prearrival notification time on adherence to Advanced Trauma Life Support (ATLS) protocols., Materials and Methods: Pediatric trauma activations of admitted patients were analyzed by video review to determine activities performed before and after patient arrival. Using an expert model based on ATLS, fitness scores were calculated that represented model adherence, ranging from "0" (noncompliant) to "100" (completely compliant). Multivariate regression was used to determine the association between fitness values of the evaluation phases and the length of prearrival notification time and injury profiles., Results: Ninety-four patients met study criteria. The average overall fitness was 89.0 ± 7.3, with similar fitness values being observed for the primary and secondary surveys (91.5 ± 13.4 and 88.6 ± 7.7, respectively). Prearrival notification time ranged from 67.3 min before to 4.8 min after patient arrival. Longer prearrival notification time was associated with improved completion of prearrival tasks, overall resuscitation performance, and secondary survey performance. The positive association of overall and secondary survey fitness with notification time was no longer observed when notification time was <5 min and <10 min, respectively. Notification time was correlated with a higher percentage of required team members when the patient arrived (Pearson correlation coefficient 0.46, P < 0.001)., Conclusions: Prearrival notification time has a significant impact on adherence to ATLS protocol. Strategies for improving notification time or improving performance when adequate notification cannot be achieved are needed., (Copyright © 2019. Published by Elsevier Inc.)
- Published
- 2019
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