A STUDY TO ASSESS WHETHER THE CLINICAL BACKGROUND OF A PAEDIATRIC TRAUMA TEAM LEADER AFFECTS THEIR CHOICE OF IMAGING MODALITY IN COMPARABLE TRAUMA PATIENTS

The management of paediatric trauma patients can be complex, involving a coordinated multidisciplinary approach. Paediatricians form an integral part of the trauma team and are often tasked with managing circulation. In this article, we will discuss the assessment of catastrophic haemorrhage and ‘circulation’ through the viewpoint of a paediatrician via a case discussion. This will include initial investigations and management, noting the time critical nature in identifying and stopping catastrophic haemorrhage. The discussion will comment on how to address hypovolaemic shock and touch on the role of imaging.

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The Effect of a Multidisciplinary Trauma Team Leader Paradigm at a Tertiary Trauma Center: 10-Year Experience

Emergency Medicine International ◽

10.1155/2020/8412179 ◽

2020 ◽

Vol 2020 ◽

pp. 1-8

Author(s):

Olivier Lavigueur ◽

Joe Nemeth ◽

Tarek Razek ◽

Nisreen Maghraby

Keyword(s):

Length Of Stay ◽

Trauma Center ◽

Rate Ratio ◽

Trauma Team ◽

Relative Reduction ◽

Trauma Patients ◽

Admission Rates ◽

Icu Length Of Stay ◽

Trauma Team Leader ◽

The Impact

Background. To illustrate the impact of the implementation of a multidisciplinary TTL program in 2005 on the mortality of trauma patients in a level 1 trauma center as well as admission rates and length of stay. Methods. Retrospective observational study of all trauma patients included in the provincial trauma database at the Montreal General Hospital between 1998 and 2015. The primary outcome studied was in-hospital mortality. The secondary outcomes studied were hospital and intensive care unit (ICU) rates of admission and hospital and ICU length of stay. Results. 24,107 patients were included. We observed a statistically significant reduction in mortality of 1.25% or a relative reduction of 16% (p value = 0.0058; rate ratio 0.844 (95% CI 0.747–0.952)). ICU admissions were also significantly reduced where we observed a statistically significant absolute reduction of 4.46% or a relative reduction of 14% (p value = 8.38 × 10−7; rate ratio 0.859 (95% CI 0.808–0.912)). The ICU length of stay was increased by 0.91 days or 19.03% (p value = 0.016 (95% CI 0.167–1.655)). There was no observed change in overall length of stay (13.97 days pre-TTL and 12.91 post-TTL (p value = 0.13; estimate −1.053 (95% CI −2.424–0.318))). Conclusions. This article suggests that multidisciplinary TTL model may be beneficial in the care of trauma patients. Further subgroup analysis may help determine which patients could benefit more.

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250: Impact of the Implementation of Emergency Physician Trauma Team Leader Coverage on Patients With Severe Trauma

Annals of Emergency Medicine ◽

10.1016/j.annemergmed.2008.01.220 ◽

2008 ◽

Vol 51 (4) ◽

pp. 547

Author(s):

A. Grunfeld ◽

I. MacPhail ◽

R. Van Heast ◽

I. Khan

Keyword(s):

Emergency Physician ◽

Trauma Team ◽

Severe Trauma ◽

Team Leader ◽

Trauma Team Leader

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Establishing an evaluation tool for trauma team leader performance during trauma resuscitation

The Southwest Respiratory and Critical Care Chronicles ◽

10.12746/swrccc.v7i28.543 ◽

2019 ◽

Vol 7 (28) ◽

pp. 38-43

Author(s):

Faiz Tuma ◽

Aussama Nassar ◽

Theresa Elder ◽

Susan Reid

Keyword(s):

Assessment Tool ◽

Pediatric Trauma ◽

Trauma Team ◽

Team Leader ◽

Health Science ◽

Team Leaders ◽

Evaluation Tool ◽

Trauma Training ◽

Leader Performance ◽

Trauma Team Leader

Introduction: Trauma training is an important part of medical and surgical education.Evaluation of training is an essential part of medical education. A formal valid assessmentmethod for trauma training is not available. The purpose of this study is to establish a formaland scientifically-based Trauma Team Leader Evaluation Tool.Methods and Results: A literature review was conducted on the assessment of traumateam leaders. The available published studies were reviewed and assessed, as well asreferences on the principles and practice of assessment methods used in medical education.Input on points of assessment was obtained from trauma team leaders at the HamiltonGeneral Hospital. An evaluation form was formulated with five domains, each containing fiveitems. Definitions of the domains and items were clarified and attached to the form. The formwas reviewed and revised by trauma team leaders of adult trauma and education leadersin pediatric trauma at Hamilton General Hospital and Health Science Education ProgramMcMaster University and then finalized based on the discussed suggestions.Conclusions: Assessment of trauma team leader performance is an important part oftrauma training and feedback. Developing an assessment tool involves a comprehensiveprocess that needs review, input, and participation from various sources related to trauma.More work to validate the tool will be needed to evaluate its utility.

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Head, Neck and Dental Emergencies

Anaesthesia, Pain & Intensive Care ◽

10.35975/apic.v23i2.1084 ◽

2019 ◽

pp. 240-241

Author(s):

Dr. Muhammad Aasam Masoom Maan

Keyword(s):

United Kingdom ◽

Trauma Team ◽

Team Leader ◽

University Hospital ◽

Critical Conditions ◽

Trauma Team Leader ◽

The University ◽

Head Neck ◽

Depth View

Head, Neck and Dental Emergencies is a welcome addition to the popular pocket reference Oxford paperback series. The Second Edition is a revised and upgraded version of the original which was published in 2005. As is evident from the title, the genre revolves explicitly around trauma and other critical conditions involving the major organs residing above the collar bone. The book imparts an in-depth view into the medical and dental aspects of emergencies encountered primarily in the Oral and Maxillofacial setting. The editor, Dr. Mike Perry, is a consultant Maxillofacial Surgeon and Trauma team leader at the University Hospital of North Staffordshire, United Kingdom, who, along with a handful of noteworthy contributors, aptly bestow extensive expertise throughout the course of the book.

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The Preferred Attributes of a Trauma Team Leader: Evidence From a Discrete Choice Experiment

Journal of Surgical Education ◽

10.1016/j.jsurg.2018.06.021 ◽

2019 ◽

Vol 76 (1) ◽

pp. 120-126 ◽

Cited By ~ 1

Author(s):

David Mo ◽

Nathan N. O'Hara ◽

Ross Hengel ◽

Alexander R. Cheong ◽

Ash Singhal

Keyword(s):

Discrete Choice Experiment ◽

Discrete Choice ◽

Choice Experiment ◽

Trauma Team ◽

Team Leader ◽

Trauma Team Leader

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Pathologic Fibrinolysis is More Common in a Rural Trauma Setting

The American Surgeon ◽

10.1177/0003134820973726 ◽

2020 ◽

pp. 000313482097372

Author(s):

James M. Bardes ◽

Daniel J. Grabo ◽

Sijin Wen ◽

Alison Wilson

Keyword(s):

Trauma Team ◽

Rural Environment ◽

Trauma Patients ◽

Future Studies ◽

Factors Influencing ◽

American College Of Surgeons ◽

Level 1 ◽

Transferred Patients ◽

Prehospital Time ◽

Level 1 Trauma Center

Introduction Fibrinolysis (lysis) has been extensively studied in trauma patients. Many studies on the distribution of lysis phenotype have been conducted in setting with short prehospital time. This study aimed to evaluate the distribution of lysis phenotypes in a population with prolonged prehospital times in a rural environment. Methods A retrospective study was performed at an American College of Surgeons-verified level 1 trauma center, serving a large rural population. Full trauma team activations from January 1, 2017 to August 31, 2018 were evaluated, and all patients with an ISS>15 analyzed. Thromboelastography was routinely performed on all participants on arrival. Lysis phenotypes were classified based on LY30 results: shutdown (≤.8%), physiologic (.9-2.9%), and hyper (>2.9%). Results 259 patients were evaluated, 134 (52%) presented direct from the scene. For scene patients, lysis distribution was 24% physiologic, 49% shutdown, and 27% hyper. Transferred patients demonstrated a reduction in physiologic lysis to 14% ( P = .03), shutdown present in 66%, and hyper in 20%. Empiric prehospital tranexamic acid was given to 18 patients, physiologic lysis was present in 6%, shutdown 72%, and hyper 22%; this increase was not statistically significant ( P = .5). Conclusion Fibrinolysis phenotypes are not consistent across all trauma populations. This study showed rural trauma patients had a significantly increased rate of pathologic lysis. This was consistent for scene and transfer patients who received care at another facility prior to arrival for definitive care. Future studies to evaluate the factors influencing these differences are warranted.

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