Timeliness of multi-detector computed tomography (MDCT) reports of the severely injured patients (SIP) in a major trauma centre

2017 ◽  
Vol 72 ◽  
pp. S11
Author(s):  
Nawaraj Subedi ◽  
Shakir Syed ◽  
Syed Ali ◽  
Chooi Oh ◽  
Vinay Parmar ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Major Trauma ◽  
Trauma Centre ◽  
Severely Injured ◽  
Severely Injured Patients ◽  
Major Trauma Centre ◽  
Injured Patients ◽  
Multi Detector Computed Tomography

Undertriage of the elderly major trauma patient continues in major trauma centre care: a retrospective cohort review

2020 ◽  
pp. emermed-2019-208541
Author(s):  
Antonia C Hoyle ◽  
Leela C Biant ◽  
Mike Young
Keyword(s):  
Older Patients ◽  
Major Trauma ◽  
Trauma Team ◽  
Trauma Centre ◽  
Trauma Patients ◽  
Severely Injured ◽  
Severely Injured Patients ◽  
Major Trauma Centre ◽  
Trauma Triage ◽  
Injured Patients

BackgroundMajor trauma (Injury Severity Score (ISS) ≥16) in older people is increasing, but concerns persist that major trauma is not always recognised in older patients on triage. This study compared undertriage of older and younger adult major trauma patients in the major trauma centre (MTC) setting to investigate this concern.MethodsA retrospective review of Trauma Audit and Research Network data was conducted for three MTCs in the UK for 3 months in 2014. Age, ISS, injury mechanism and injured areas were examined for all severely injured patients (ISS ≥16) and appropriate major trauma triage rates measured via the surrogate markers of trauma team activation and the presence of a consultant first attender, as per standards for major trauma care set by National Confidential Enquiry into Patient Outcomes and Deaths, Royal College of Surgeons of England and the British Orthopaedic Association. Trends in older (age ≥65) and younger (ages 18–64) adult major trauma presentation, triage and reception were reviewed.ResultsOf 153 severely injured patients, 46 were aged ≥65. Older patients were significantly less likely to receive the attention of a consultant first attender or trauma team. Similar trends were also seen on subgroup analysis by mechanism of injury or number of injured body areas. Older major trauma patients exhibit a higher mortality, despite a lower median ISS (older patient ISS=20 (IQR 16–25), younger patient ISS=25 (IQR 18–29)).ConclusionOlder major trauma patients are at greater risk of undertriage, even in the MTC environment. Existing hospital trauma triage practices should be further investigated to explain and reduce undertriage of elderly trauma patients.

scholarly journals An assessment of pelvic binder placement at a UK major trauma centre

2018 ◽  
Vol 100 (2) ◽  
pp. 101-105 ◽  
Author(s):  
H Naseem ◽  
PD Nesbitt ◽  
DC Sprott ◽  
A Clayson
Keyword(s):  
Computed Tomography ◽  
Continuing Education ◽  
Retrospective Review ◽  
Major Trauma ◽  
Pelvic Ring ◽  
Trauma Centre ◽  
Pelvic Ring Injury ◽  
Pelvic Ring Injuries ◽  
Pelvic Binder ◽  
Major Trauma Centre

Introduction Pelvic binders are used to reduce the haemorrhage associated with pelvic ring injuries. Application at the level of the greater trochanters is required. We assessed the frequency of their use in patients with pelvic ring injuries and their positioning in patients presenting to a single major trauma centre. Methods A retrospective review of our trauma database was performed to randomly select 1000 patients for study from April 2012 to December 2016. Patients with a pelvic binder or a pelvic ring injury defined by the Young and Burgess classification were included. Computed tomography was used to identify and measure pelvic binder placement. Results 140 patients were identified: 110/140 had a binder placed. Of the total, 54 (49.1%) patients had satisfactory placement and 56 (50.9%) had unsatisfactory placement; 30/67 (44.8%) patients with a pelvic ring injury had no binder applied, of whom 6 (20%) had an unstable injury; 9/67 patients died. Discussion This is the first study assessing pelvic binder placement in patients at a UK major trauma centre. Unsatisfactory positioning of the pelvic binder is a common problem and it was not used in a large proportion of patients with pelvic ring injuries. This demonstrates that there is a need for continuing education for teams dealing with major trauma.

Is trauma centre care helpful for less severely injured patients?

Injury ◽  
2005 ◽  
Vol 36 (11) ◽  
pp. 1293-1297 ◽  
Author(s):  
Thomas S. Helling ◽  
Paul W. Nelson ◽  
B. Todd Moore ◽  
Denise Kintigh ◽  
Kathy Lainhart
Keyword(s):  
Trauma Centre ◽  
Severely Injured ◽  
Severely Injured Patients ◽  
Injured Patients

Time to computed tomography: does this affect trauma patient outcomes? A retrospective analysis at an Australian major trauma centre

2019 ◽  
Vol 89 (11) ◽  
pp. 1475-1479
Author(s):  
Cedric L. H. Ng ◽  
Jason Kim ◽  
Ben Dobson ◽  
Don Campbell ◽  
Martin Wullschleger
Keyword(s):  
Computed Tomography ◽  
Trauma Patient ◽  
Retrospective Analysis ◽  
Patient Outcomes ◽  
Major Trauma ◽  
Trauma Centre ◽  
Major Trauma Centre

The Role of Whole-Body Computed Tomography in Severely Injured Patients Retrospective Single Center Cohort Study

2016 ◽  
Vol 6 (1) ◽  
pp. 18-22
Author(s):  
Hyun-Woo Sun ◽  
Suk-Kyung Hong ◽  
Min-Ae Keum ◽  
Jong-Kwan Baek ◽  
Jung-Sun Lee ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cohort Study ◽  
Whole Body ◽  
Severely Injured ◽  
Single Center ◽  
Severely Injured Patients ◽  
Whole Body Computed Tomography ◽  
Injured Patients

scholarly journals mTICCS and its inter-rater reliability to predict the need for massive transfusion in severely injured patients

2020 ◽  
Author(s):  
Klemens Horst ◽  
Philipp Lichte ◽  
Felix Bläsius ◽  
Christian David Weber ◽  
Martin Tonglet ◽  
...  
Keyword(s):  
Massive Transfusion ◽  
Scoring Systems ◽  
Clinical Score ◽  
Trauma Centre ◽  
Medical Professionals ◽  
Severely Injured ◽  
Severely Injured Patients ◽  
Rater Reliability ◽  
Significant Difference ◽  
Injured Patients

Abstract Purpose The modified Trauma-Induced Coagulopathy Clinical Score (mTICCS) presents a new scoring system for the early detection of the need for a massive transfusion (MT). This easily applicable score was validated in a large trauma cohort and proven comparable to more established complex scoring systems. However, the inter-rater reliability of the mTICCS has not yet been investigated. Methods Therefore, a dataset of 15 randomly selected and severely injured patients (ISS ≥ 16) derived from the database of a level I trauma centre (2010–2015) was used. Moreover, 15 severely injured subjects that received MT were chosen from the same databank. A web-based survey was sent to medical professionals working in the field of trauma care asking them to evaluate each patient using the mTICCS. Results In total, 16 raters (9 residents and 7 specialists) completed the survey. Ratings from 15 medical professionals could be evaluated and led to an ICC of 0.7587 (95% Bootstrap confidence interval (BCI) 0.7149–0.8283). A comparison of working experience specific ICC (n = 7 specialists, ICC: 0.7558, BCI: 0.7076–0.8270; n = 8 residents, ICC: 0.7634, BCI: 0.7183–0.8335) showed no significant difference between the two groups (p = 0.67). Conclusion In summary, reliability values need to be considered when making clinical decisions based on scoring systems. Due to its easy applicability and its almost perfect inter-rater reliability, even with non-specialists, the mTICCS might therefore be a useful tool to predict the early need for MT in multiple trauma.

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