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Association Between Prearrival Notification Time and Advanced Trauma Life Support Protocol Adherence
Journal article   Open access   Peer reviewed

Association Between Prearrival Notification Time and Advanced Trauma Life Support Protocol Adherence

Omar Z Ahmed, Sen Yang, Richard A Farneth, Aleksandra Sarcevic, Ivan Marsic and Randall S Burd
The Journal of surgical research, v 242, pp 231-238
Oct 2019
PMID: 31100569
url
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6800195View
Accepted (AM)Open Access (License Unspecified) Open

Abstract

Guideline Adherence - statistics & numerical data Triage - statistics & numerical data Humans Child, Preschool Hospitals, Pediatric Infant Male Wounds and Injuries - therapy Time Factors Patient Care Team - organization & administration Advanced Trauma Life Support Care - standards Female Trauma Centers - statistics & numerical data Advanced Trauma Life Support Care - statistics & numerical data Child Communication District of Columbia Patient Care Team - standards Trauma Centers - organization & administration Trauma Severity Indices Patient Care Team - statistics & numerical data Triage - standards Quality Improvement Adolescent Wounds and Injuries - diagnosis Video Recording Triage - organization & administration Trauma Centers - standards Practice Guidelines as Topic
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. 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. 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). 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.

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Collaboration types
Domestic collaboration
Web of Science research areas
Surgery
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