ChIP: An early activation protocol for isolated blunt chest injury improves outcomes, a retrospective cohort study

Blunt chest injuries not treated in a timely manner with sufficient analgesia, physiotherapy and respiratory support are associated with increased morbidity and mortality. The aim of the study was to determine the impact of a blunt chest injury early activation protocol (ChIP) on patient and hospita...

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Bibliographic Details
Published in:Australasian emergency nursing journal 2016-08, Vol.19 (3), p.127-132
Main Authors: Curtis, Kate, Asha, Stephen E., Unsworth, Annalise, Lam, Mary, Goldsmith, Helen, Langcake, Mary, Dwyer, Donovan
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Clinical guideline
Clinical Protocols
Controlled Before-After Studies
Delivery of Health Care
Emergency
Emergency Nursing - methods
Female
Humans
Injury
Length of Stay
Male
New South Wales
Nursing
Pain management
Patient Care Team
Pneumonia - etiology
Pneumonia - nursing
Retrospective Studies
Rib fracture
Rib Fractures - nursing
Thoracic Injuries - etiology
Thoracic Injuries - nursing
Treatment Outcome
Wounds, Nonpenetrating - etiology
Wounds, Nonpenetrating - nursing
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Summary:Blunt chest injuries not treated in a timely manner with sufficient analgesia, physiotherapy and respiratory support are associated with increased morbidity and mortality. The aim of the study was to determine the impact of a blunt chest injury early activation protocol (ChIP) on patient and hospital outcomes. In this pre-post cohort study, the outcomes of patients with blunt chest injury who received ChIP were compared against those who did not. Data including injury severity, patient outcomes, hospital treatments and comorbidites were extracted from medical records. The primary outcome was pneumonia. Secondary outcomes evaluated health service delivery. Logistic and multiple regressions were used to adjust for potential confounding variables. 546 patients were included, 273 in the before-ChIP cohort and 273 in the after-ChIP cohort. The incidence of pneumonia following the introduction of ChIP was reduced by 4.8% (95% CI 0.5–9.2, p=0.03). In the after-ChIP cohort, more patients received a pain team review (32% vs. 13%, p
ISSN:1574-6267
1839-2776
DOI:10.1016/j.aenj.2016.06.002