Trauma resource pit stop: increasing efficiency in the evaluation of lower severity trauma patients

• Published in: Trauma surgery & acute care open 2021-04, Vol.6 (1), p.e000670-e000670
• Main Authors: Dandan, Imad S, Tominaga, Gail T, Zhao, Frank Z, Schaffer, Kathryn B, Nasrallah, Fady S, Gawlik, Melanie, Bayat, Dunya, Dandan, Tala H, Biffl, Walter L
• Format: Article
• Language: English
• Subjects: Anticoagulants; Efficiency; field triage; Fractures; Geriatrics; Hospitals; Injuries; Medical imaging; Mortality; Original Research; Patients; Physiology; resource; Trauma; trauma activation; Trauma centers; trauma triage
• ISSN: 2397-5776; 2397-5776
• DOI: 10.1136/tsaco-2020-000670

BackgroundOvertriage of trauma patients is unavoidable and requires effective use of hospital resources. A ‘pit stop’ (PS) was added to our lowest tier trauma resource (TR) triage protocol where the patient stops in the trauma bay for immediate evaluation by the emergency department (ED) physician and trauma nursing. We hypothesized this would allow for faster diagnostic testing and disposition while decreasing cost.MethodsWe performed a before/after retrospective comparison after PS implementation. Patients not meeting trauma activation (TA) criteria but requiring trauma center evaluation were assigned as a TR for an expedited PS evaluation. A board-certified ED physician and trauma/ED nurse performed an immediate assessment in the trauma bay followed by performance of diagnostic studies. Trauma surgeons were readily available in case of upgrade to TA. We compared patient demographics, Injury Severity Score, time to physician evaluation, time to CT scan, hospital length of stay, and in-hospital mortality. Comparisons were made using 95% CI for variance and SD and unpaired t-tests for two-tailed p values, with statistical difference, p