CJEM
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Severely injured patients benefit from early identification and trauma centre treatment. Ontario has provincial prehospital trauma triage guidelines identifying patients who require direct trauma centre transport. Trauma patients not identified as meeting this provincial trauma triage standard are brought to the closest non-trauma hospital and may later be transferred to a trauma centre by a secondary interfacility transfer. Secondary interfacility transfers cause significant delays in receiving definitive care which have been associated with worse outcomes. The objective of this study was to determine the frequency that patients who underwent emergent secondary interfacility trauma transfer initially met prehospital trauma triage guidelines, as well as to assess the approximate delay to trauma centre care. ⋯ Patients who meet trauma triage criteria that end up undergoing secondary interfacility transfer experience significant delays. We recommend adding recreational vehicle collisions as a triage criterion. Emergency physicians should work with their local paramedic services to ensure severely injured patients are identified early to expedite transport.
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Trauma resuscitations are sporadic, high-acuity situations and conducting observation in the trauma bay for the purpose of quality improvement is challenging. We aim to review contemporary uses of trauma video review. ⋯ This study highlights common uses of trauma video review. The greatest benefit for this new technology is in quality improvement and education. The majority of studies focussed on critical procedures and QI initiatives, such as checklists, protocols and continued education. We recommend adoption of video review systems for ongoing improvement of team dynamics and overall trauma and emergency resuscitation.