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Matthews T, LaScala A, Tomkin T, Gaeta L, Fitzgerald K, Solomita M, Ragione B, Jahan TP, Pepic S, Apurillo L, Siegel V, Frederick A, Arrillaga A, Klein LR, Cuellar J, Raio C, Penta K, Rothburd L, Eckardt SA, Eckardt P. Resource Deployment in Response to Trauma Patients. Cureus 2023; 15:e49979. [PMID: 38058531 PMCID: PMC10697664 DOI: 10.7759/cureus.49979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/05/2023] [Indexed: 12/08/2023] Open
Abstract
Background Variance in the deployment of the trauma team to the emergency department (ED) can result in patient treatment delays and excess burden on ED personnel. Characteristics of trauma patients, including mechanism of injury, injury type, and age, have been associated with differences in trauma resource deployment. Therefore, this retrospective, single-site study aimed to examine the deployment patterns of trauma resources, the characteristics of the trauma patients associated with levels of trauma resource deployment, and the deployment impact on ED workforce utilization and non-trauma ED patients. Methodology This was an investigator-initiated, single-institution, retrospective cohort study of all patients designated as a trauma response and admitted to a community hospital's ED from July 01, 2019, through July 01, 2022. Results Resource deployment for trauma patients varied by mechanism of injury (p < 0.001), injury type (p < 0.001), and patient age groups (p < 0.001). Specifically, there was a lower average trauma activation for geriatric trauma patients with a fall as a mechanism of injury compared to all younger patient groups with any mechanism of injury (F(5) = 234.49, p < 0.001). In the subsample, there was an average of 3.35 ED registered nurses (RNs) allocated to each trauma patient. Additionally, the ED RNs were temporarily reallocated from an average of 4.09 non-trauma patients to respond to trauma patients, despite over a third of the trauma patients in the subsample being the trauma patients being discharged home from the ED. Conclusions Trauma activation responses need to be standardized with a specific plan for geriatric fall patients to ensure efficient use of trauma and ED personnel resources.
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Affiliation(s)
- Thomas Matthews
- Nursing, Good Samaritan University Hospital, West Islip, USA
| | - Alexa LaScala
- Nursing, Good Samaritan University Hospital, West Islip, USA
| | - Theresa Tomkin
- Nursing, Good Samaritan University Hospital, West Islip, USA
| | - Lisa Gaeta
- Nursing, Good Samaritan University Hospital, West Islip, USA
| | - Karen Fitzgerald
- Quality Improvement, Good Samaritan University Hospital, West Islip, USA
| | - Michele Solomita
- Nursing Administration, Good Samaritan University Hospital, West Islip, USA
| | - Barbara Ragione
- Quality Improvement, Good Samaritan University Hospital, West Islip, USA
| | | | - Saliha Pepic
- Research, City University of New York, New York, USA
| | | | | | - Amy Frederick
- Trauma, Good Samaritan University Hospital, West Islip, USA
| | - Abenamar Arrillaga
- Surgical Critical Care, Good Samaritan University Hospital, West Islip, USA
| | - Lauren R Klein
- Emergency Medicine, Good Samaritan University Hospital, West Islip, USA
| | - John Cuellar
- Orthopedic Surgery, Good Samaritan University Hospital, West Islip, USA
| | - Christopher Raio
- Emergency Medicine, Good Samaritan University Hospital, West Islip, USA
| | - Keri Penta
- Nursing/Performance Improvement, Good Samaritan University Hospital, West Islip, USA
| | | | - Sarah A Eckardt
- Data Scientist, Eckardt & Eckardt Consulting, LLC, St. James, USA
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