Polytrauma management in a period of change: time analysis of new strategies for emergency room treatment

• Published in: Der Unfallchirurg 2009-04, Vol.112 (4), p.390-399
• Main Authors: Wurmb, T, Balling, H, Frühwald, P, Keil, T, Kredel, M, Meffert, R, Roewer, N, Brederlau, J
• Format: Article
• Language: ger
• Subjects: Emergency Service, Hospital - statistics & numerical data; Germany; Humans; Multiple Trauma - diagnostic imaging; Multiple Trauma - therapy; Quality Assurance, Health Care; Resuscitation - statistics & numerical data; Time and Motion Studies; Time Factors; Tomography, X-Ray Computed - statistics & numerical data; Whole Body Imaging - statistics & numerical data; Workload - statistics & numerical data
• ISSN: 1433-044X
• DOI: 10.1007/s00113-008-1528-3

Quality management and the early implementation of whole-body multi-slice spiral computed tomography (whole-body MSCT) are becoming increasingly important in the management of patients with multiple trauma. The aim of this study was to evaluate both components with respect to the time factor for treatment. The investigation involved a retrospective data analysis of the time needed in the emergency room for the initial stabilization (phase A), completing the diagnosis (phase B) and the emergency room treatment (phase C). The investigation included three groups: trauma patients imaged in the emergency room with conventional imaging procedures (group I), with whole-body MSCT alone (group II) and those who were imaged with whole-body MSCT after the introduction of a quality management system with standard operating procedures (group III). The times for resuscitation (phase A), for diagnostic evaluation (phase B) and for total treatment (phase C) were analyzed. The times for phase A were for group I (n=79) 10 min (interquartile range, IQR 8-12 min), group II (n=82) 13 min (IQR 10-17 min) and group III (n=79) 10 min (IQR 8-15 min; p