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Heesters V, van Zanten HA, de Boer LC, Visser R, Heijstek V, Te Pas AB, Witlox RS. Quality improvement initiative: implementing and redefining video review of real-time neonatal procedures using action research. BMJ Open Qual 2024; 13:e002588. [PMID: 38749540 PMCID: PMC11097868 DOI: 10.1136/bmjoq-2023-002588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 04/24/2024] [Indexed: 05/18/2024] Open
Abstract
Video review (VR) of procedures in the medical environment can be used to drive quality improvement. However, first it has to be implemented in a safe and effective way. Our primary objective was to (re)define a guideline for implementing interprofessional VR in a neonatal intensive care unit (NICU). Our secondary objective was to determine the rate of acceptance by providers attending VR. For 9 months, VR sessions were evaluated with a study group, consisting of different stakeholders. A questionnaire was embedded at the end of each session to obtain feedback from providers on the session and on the safe learning environment. In consensus meetings, success factors and preconditions were identified and divided into different factors that influenced the rate of adoption of VR. The number of providers who recorded procedures and attended VR sessions was determined. A total of 18 VR sessions could be organised, with an equal distribution of medical and nursing staff. After the 9-month period, 101/125 (81%) of all providers working on the NICU attended at least 1 session and 80/125 (64%) of all providers recorded their performance of a procedure at least 1 time. In total, 179/297 (61%) providers completed the questionnaire. Almost all providers (99%) reported to have a positive opinion about the review sessions. Preconditions and success factors related to implementation were identified and addressed, including improving the pathway for obtaining consent, preparation of VR, defining the role of the chair during the session and building a safe learning environment. Different strategies were developed to ensure findings from sessions were used for quality improvement. VR was successfully implemented on our NICU and we redefined our guideline with various preconditions and success factors. The adjusted guideline can be helpful for implementation of VR in emergency care settings.
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Affiliation(s)
- Veerle Heesters
- Department of Paediatrics, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Linsey Cc de Boer
- Department of Paediatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - Remco Visser
- Department of Paediatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - Veerle Heijstek
- Department of Paediatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - Arjan B Te Pas
- Department of Paediatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - Ruben Sgm Witlox
- Department of Paediatrics, Leiden University Medical Center, Leiden, The Netherlands
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Koko JAB, Mohamed OSA, Koko BAB, Musa OAY. The ABCDE approach: Evaluation of adherence in a low-income country. Injury 2024; 55:111268. [PMID: 38097486 DOI: 10.1016/j.injury.2023.111268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 11/23/2023] [Accepted: 12/01/2023] [Indexed: 04/19/2024]
Abstract
BACKGROUND Early recognition and initial treatment of trauma patients prevents deterioration and buys time for making a definitive diagnosis. The "Airway, Breathing, Circulation, Disability and Exposure" (ABCDE) approach should be used whenever an injury is suspected. It provides quick identification and management of life-threatening problems. Still, there is limited knowledge regarding adherence to the ABCDE approach. This research aims to assess the adherence of the trauma team members to the ABCDE approach in the management of major trauma patients and the factors affecting it. METHOD The study is a cross-sectional hospital-based study conducted in the trauma and resuscitation rooms of major governmental hospitals in Khartoum in the period from Jan.30, 2022, to Mar.29, 2022. It was done among the medical staff dealing with major trauma cases. Data were collected by observation using a modified standardized checklist for assessing the ABCDE approach and via a self-administered questionnaire for identifying the factors affecting adherence. Total coverage of all major trauma cases resuscitation (n = 50) was done. Also, a sample size of 158 medical staff was covered for the questionnaire. The data was analyzed in Statistical Package for the Social Science (SPSS) V.23. RESULTS The mean percentage of adherence to the ABCDE approach was 37.9 % (SD 15.44). When the ABCDE sequence was not followed, the ACB was the commonest sequence. Also, adherence had no significant relation with any patient or staff-related factor. The main present obstacles to adherence to the ABCDE approach were overcrowding in the room and unprepared facilities. While the major present facilitator was the clinical experience. CONCLUSION The adherence rate was low, but initiation of the ABCDE approach was rapid. The factors participating in low adherence rates were usually facility or population-based factors. We recommend further studies, further training and embedment of guidelines, and the provision of larger trauma rooms with adequate supplies.
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Affiliation(s)
- Julia Adam Bashir Koko
- Faculty of Medicine, University of Medical Sciences and Technology (UMST), Khartoum, Sudan.
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Aukstakalnis V, Stucinskas J, Dobozinskas P, Darginavicius L, Stasaitis K, Vaitkaitis D. Impact of video recordings review with structured debriefings on trauma team performance: a prospective observational cohort study. Eur J Trauma Emerg Surg 2024:10.1007/s00068-024-02473-3. [PMID: 38393363 DOI: 10.1007/s00068-024-02473-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 02/09/2024] [Indexed: 02/25/2024]
Abstract
PURPOSE To determine the impact of structured debriefings (SD) with audio/video review of trauma patients' resuscitation events on trauma team (TT) technical and non-technical skills. METHODS Single-center prospective observational cohort study. The study included all emergency department patients aged 18 years or older who received resuscitation from the TT. Virtual meeting was held with the TT using SD to review one trauma patient resuscitation video. Technical skills improvement was based on adherence to the ATLS protocol and non-technical skills based on T-NOTECHS scale. RESULTS There was statistically significant improvement in adherence to the ATLS protocol: 73% [55-82%] vs 91% [82-100%] (p < 0.001); and improvement in T-NOTECHS scale: 12 [10-14] vs 16 [14-19] points (p < 0.001). CONCLUSION In this study, we found that structured debriefings with review of patients' resuscitation video recordings can have a significant positive impact on trauma team performance in the emergency department in both technical and non-technical skills.
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Affiliation(s)
- Vytautas Aukstakalnis
- Department of Emergency Medicine, Lithuanian University of Health Sciences, Eiveniu g. 2, Kaunas, Lithuania.
| | - Justinas Stucinskas
- Department of Orthopaedics and Traumatology, Lithuanian University of Health Sciences, Eiveniu g. 2, Kaunas, Lithuania
| | - Paulius Dobozinskas
- Department of Disaster Medicine, Lithuanian University of Health Sciences, Eiveniu g. 2, Kaunas, Lithuania
| | - Linas Darginavicius
- Department of Disaster Medicine, Lithuanian University of Health Sciences, Eiveniu g. 2, Kaunas, Lithuania
| | - Kestutis Stasaitis
- Department of Emergency Medicine, Lithuanian University of Health Sciences, Eiveniu g. 2, Kaunas, Lithuania
| | - Dinas Vaitkaitis
- Department of Disaster Medicine, Lithuanian University of Health Sciences, Eiveniu g. 2, Kaunas, Lithuania
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Maiga AW, Vella MA, Appelbaum RD, Irlmeier R, Ye F, Holena DN, Dumas RP. Getting out of the bay faster: Assessing trauma team performance using trauma video review. J Trauma Acute Care Surg 2024; 96:76-84. [PMID: 37880840 DOI: 10.1097/ta.0000000000004168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2023]
Abstract
BACKGROUND Minutes matter for trauma patients in hemorrhagic shock. How trauma team function impacts time to the next phase of care has not been rigorously evaluated. We hypothesized better team performance scores to be associated with decreased time to the next phase of trauma care. METHODS This retrospective secondary analysis of a prospective multicenter observational study included hypotensive trauma patients at 19 centers. Using trauma video review, we analyzed team performance with the validated Non-Technical Skills for Trauma scale: leadership, cooperation and resource management, communication, assessment/decision making, and situational awareness. The primary outcome was minutes from patient arrival to next phase of care; deaths in the bay were excluded. Secondary outcomes included time to initiation and completion of first unit of blood and inpatient mortality. Associations between team dynamics and outcomes were assessed with a linear mixed-effects model adjusting for Injury Severity Score, mechanism, initial blood pressure and heart rate, number of team members, and trauma team lead training level and sex. RESULTS A total of 441 patients were included. The median Injury Severity Score was 22 (interquartile range, 10-34), and most (61%) sustained blunt trauma. The median time to next phase of care was 23.5 minutes (interquartile range, 17-35 minutes). Better leadership, communication, assessment/decision making, and situational awareness scores were associated with faster times to next phase of care (all p < 0.05). Each 1-point worsening in the Non-Technical Skills for Trauma scale score (scale, 5-15) was associated with 1.6 minutes more in the bay. The median resuscitation team size was 12 (interquartile range, 10-15), and larger teams were slower ( p < 0.05). Better situational awareness was associated with faster completion of first unit of blood by 4 to 5 minutes ( p < 0.05). CONCLUSION Better team performance is associated with faster transitions to next phase of care in hypotensive trauma patients, and larger teams are slower. Trauma team training should focus on optimizing team performance to facilitate faster hemorrhage control. LEVEL OF EVIDENCE Therapeutic/Care Management; Level III.
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Affiliation(s)
- Amelia W Maiga
- From the Division of Acute Care Surgery, Department of Surgery (A.W.M., R.D.A.), Section of Surgical Sciences, Vanderbilt University Medical Center, Nashville, Tennessee; Critical Illness, Brain dysfunction, and Survivorship Center (A.W.M.), Vanderbilt University Medical Center, Nashville, Tennessee; Division of Acute Care Surgery and Trauma (M.A.V.), University of Rochester Medical Center, Rochester, New York; Department of Biostatistics (R.I.), Vanderbilt University Medical Center, Nashville, Tennessee; Department of Medicine (F.Y.), Vanderbilt University Medical Center, Nashville, Tennessee; Division of Trauma and Acute Care Surgery (D.N.H.), Medical College of Wisconsin, Milwaukee, Wisconin; and Division of Burn Trauma Acute and Critical Care Surgery (R.P.D.), UT Southwestern Medical Center, Dallas, Texas
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Alexander EG, Denny F, Gordon MW, McKiernan C, Lowe DJ. Evaluation of video review tools for assessing non-technical skills in emergency department resuscitation teams: a systematic review. BMC Emerg Med 2023; 23:141. [PMID: 38030981 PMCID: PMC10687788 DOI: 10.1186/s12873-023-00895-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 10/17/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND AND IMPORTANCE Use of video review in medicine is established in contexts such as surgery. Although not widely used in the emergency department (ED), some centres use it to evaluate non-technical skills (NTS) to support teaching and quality improvement. OBJECTIVE There is no consensus on assessment of NTS using video review in the ED and the purpose of this review was to identify tools used in this context. DESIGN, SETTING AND PARTICIPANTS Studies were identified using Embase, Medline, CINAHL and Google Scholar. Inclusion criterion for the review was NTS of resuscitation teams working within the ED were assessed using video review. A systematic search method was used, and results were synthesised after search criteria was checked by two independent reviewers. Authors settled on the same 9 studies eligible for inclusion. OUTCOME MEASURES AND ANALYSIS Reliability and validity of tools identified for use in this context. Due to the heterogeneity of studies, no meta-analysis occurred. MAIN RESULTS There are 9 studies included in the review. The review was registered with PROSPERO (Ref No: CRD42022306129). Four unique tools were identified - 6 studies used T-NOTECHS, 1 used TTCA-24, 1 used CALM and 1 used the Communication tool. T-NOTECHS is validated in the literature for use in this context. CONCLUSION T-NOTECHS is the tool of choice for assessing ED teams in this context.
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Affiliation(s)
| | - Fraser Denny
- University of Glasgow, Glasgow, UK
- Queen Elizabeth University Hospital, Glasgow, UK
| | - Malcom Wg Gordon
- University of Glasgow, Glasgow, UK
- Queen Elizabeth University Hospital, Glasgow, UK
| | - Cieran McKiernan
- University of Glasgow, Glasgow, UK
- Queen Elizabeth University Hospital, Glasgow, UK
| | - David J Lowe
- University of Glasgow, Glasgow, UK.
- Queen Elizabeth University Hospital, Glasgow, UK.
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK.
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Lapierre A, Lavoie P, Castonguay V, Lonergan AM, Arbour C. The influence of the simulation environment on teamwork and cognitive load in novice trauma professionals at the emergency department: Piloting a randomized controlled trial. Int Emerg Nurs 2023; 67:101261. [PMID: 36804137 DOI: 10.1016/j.ienj.2022.101261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 12/16/2022] [Accepted: 12/29/2022] [Indexed: 02/20/2023]
Abstract
INTRODUCTION This pilot study aimed to test the feasibility of conducting a randomized controlled trial to examine how simulation environments (in situ versus laboratory) influence teamwork skills development and cognitive load among novice healthcare trauma professionals in the emergency department. METHOD Twenty-four novice trauma professionals (nurses, medical residents, respiratory therapists) were assigned to in situ or laboratory simulations. They participated in two 15-minute simulations separated by a 45-minute debriefing on teamwork. After each simulation, they completed validated teamwork and cognitive load questionnaires. All simulations were video recorded to assess teamwork performance by trained external observers. Feasibility measures (e.g., recruitment rate, randomization procedure and intervention implementation) were recorded. Mixed ANOVAs were used to calculate effect sizes. RESULTS Regarding feasibility, several difficulties were encountered, such as a low recruitment rate and the inability to perform randomization. Outcome results suggest that the simulation environment does not affect novice trauma professionals' teamwork performance and cognitive load (small effect sizes), but a large effect size was observed for perceived learning. CONCLUSION This study highlights several barriers to conducting a randomized study in the context of interprofessional simulation-based education in the emergency department. Suggestions are made to guide future research in the field.
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Affiliation(s)
- Alexandra Lapierre
- Faculty of Nursing, Université de Montréal, 2375 Chem. de la Côte-Sainte-Catherine, Montréal, QC H3T 1A8, Canada; Research center, Hôpital du Sacré-Coeur de Montréal, 5400 Boul Gouin O, Montréal, QC H4J 1C5, Canada.
| | - Patrick Lavoie
- Faculty of Nursing, Université de Montréal, 2375 Chem. de la Côte-Sainte-Catherine, Montréal, QC H3T 1A8, Canada
| | - Véronique Castonguay
- Research center, Hôpital du Sacré-Coeur de Montréal, 5400 Boul Gouin O, Montréal, QC H4J 1C5, Canada
| | - Ann-Marie Lonergan
- Research center, Hôpital du Sacré-Coeur de Montréal, 5400 Boul Gouin O, Montréal, QC H4J 1C5, Canada
| | - Caroline Arbour
- Faculty of Nursing, Université de Montréal, 2375 Chem. de la Côte-Sainte-Catherine, Montréal, QC H3T 1A8, Canada; Research center, Hôpital du Sacré-Coeur de Montréal, 5400 Boul Gouin O, Montréal, QC H4J 1C5, Canada
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Bhangu A, Stevenson C, Szulewski A, MacDonald A, Nolan B. A scoping review of nontechnical skill assessment tools to evaluate trauma team performance. J Trauma Acute Care Surg 2022; 92:e81-e91. [PMID: 34908024 DOI: 10.1097/ta.0000000000003492] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The objective of this scoping review was to identify assessment tools of trauma team performance (outside of technical skills) and assess the validity and reliability of each tool in assessing trauma team performance. METHODS We searched Embase, Cochrane Library, Web of Science, Ovid Medline, and Cumulative Index to Nursing and Allied Health Literature from inception to June 1, 2021. English studies that evaluated trauma team performance using nontechnical skill assessment tools in a simulation or real-world setting were included. Studies were assessed by two independent reviewers for meeting inclusion/exclusion criteria. Data regarding team assessment tools were extracted and synthesized into behavior domains. Each tool was then assessed for validity and reliability. RESULTS The literature search returned 4,215 articles with 29 meeting inclusion criteria. Our search identified 12 trauma team performance assessment tools. Most studies were conducted in the United States (n = 20 [69%]). Twenty studies (69%) assessed trauma team performance in a simulation setting; Team Emergency Assessment Measure (TEAM) and Trauma Nontechnical Skills Scale (T-NOTECHS) were the only tools to be applied in a simulation and real-world setting. Most studies assessed trauma team performance using video review technology (n = 17 [59%]). Five overarching themes were designed to encompass behavioral domains captured across the 12 tools: (1) Leadership, (2) Communication, (3) Teamwork, (4) Assessment, and (5) Situation Awareness. The reliability and validity of T-NOTECHS were investigated by the greatest number of studies (n = 13); however, TEAM had the most robust evidence of reliability and validity. CONCLUSION We identified 12 trauma team performance tools that assessed nontechnical skills to varying degrees. Trauma Nontechnical Skills Scale and TEAM tools had the most evidence to support their reliability and validity. Considering the limited research in the impact of trauma team performance on patient outcomes, future studies could use video review technology in authentic trauma cases to further study this important relationship. LEVEL OF EVIDENCE Systematic reviews and meta-analyses, level IV.
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Affiliation(s)
- Avneesh Bhangu
- From the Faculty of Health Sciences (A.B.), School of Medicine, Queen's University, Kingston, Ontario, Canada; School of Medicine (C.S.), University of Limerick, Limerick, Ireland; Department of Emergency Medicine (A.S.) and Department of Psychology (A.S.), Queen's University, Kingston, Ontario; Department of Biological Sciences (A.M.), Bishop's University, Sherbrooke, Quebec; Division of Emergency Medicine, Department of Medicine (B.N.), University of Toronto; Li Ka Shing Knowledge Institute (B.N.), St. Michael's Hospital; and Department of Emergency Medicine (B.N.), St. Michael's Hospital, Toronto, Ontario, Canada
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Heesters V, Witlox R, van Zanten HA, Jansen SJ, Visser R, Heijstek V, Te Pas AB. Video recording emergency care and video-reflection to improve patient care; a narrative review and case-study of a neonatal intensive care unit. Front Pediatr 2022; 10:931055. [PMID: 35989985 PMCID: PMC9385994 DOI: 10.3389/fped.2022.931055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 07/18/2022] [Indexed: 11/17/2022] Open
Abstract
As the complexity of emergency care increases, current research methods to improve care are often unable to capture all aspects of everyday clinical practice. Video recordings can visualize clinical care in an objective way. They can be used as a tool to assess care and to reflect on care with the caregivers themselves. Although the use of video recordings to reflect on medical interventions (video-reflection) has increased over the years, it is still not used on a regular basis. However, video-reflection proved to be of educational value and can improve teams' management and performance. It has a positive effect on guideline adherence, documentation, clinical care and teamwork. Recordings can also be used for video-reflexivity. Here, caregivers review recordings together to reflect on their everyday practice from new perspectives with regard to context and conduct in general. Although video-reflection in emergency care has proven to be valuable, certain preconditions have to be met and obstacles need to be overcome. These include gaining trust of the caregivers, having a proper consent-procedure, maintaining confidentiality and adequate use of technical equipment. To implement the lessons learned from video-reflection in a sustainable way and to continuously improve care, it should be integrated in regular simulation training or education. This narrative review will describe the development of video recording in emergency care and how video-reflection can improve patient care and safety in new ways. On our own department, the NICU at the LUMC, video-reflection has already been implemented and we want to further expand this. We will describe the use of video-reflection in our own unit. Based on the results of this narrative review we will propose options for future research to increase the value of video-reflection.
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Affiliation(s)
- Veerle Heesters
- Division of Neonatology, Department of Paediatrics, Willem-Alexander Children's Hospital, Leiden University Medical Center, Leiden, Netherlands
| | - Ruben Witlox
- Division of Neonatology, Department of Paediatrics, Willem-Alexander Children's Hospital, Leiden University Medical Center, Leiden, Netherlands
| | - Henriette A van Zanten
- Division of Neonatology, Department of Paediatrics, Willem-Alexander Children's Hospital, Leiden University Medical Center, Leiden, Netherlands
| | - Sophie J Jansen
- Division of Neonatology, Department of Paediatrics, Willem-Alexander Children's Hospital, Leiden University Medical Center, Leiden, Netherlands
| | - Remco Visser
- Division of Neonatology, Department of Paediatrics, Willem-Alexander Children's Hospital, Leiden University Medical Center, Leiden, Netherlands
| | - Veerle Heijstek
- Division of Neonatology, Department of Paediatrics, Willem-Alexander Children's Hospital, Leiden University Medical Center, Leiden, Netherlands
| | - Arjan B Te Pas
- Division of Neonatology, Department of Paediatrics, Willem-Alexander Children's Hospital, Leiden University Medical Center, Leiden, Netherlands
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Aukstakalnis V, Blaziene K, Cepla J, Vileitaite G, Stasaitis K, Vaitkaitis D. Impact of the COVID-19 lockdown on trauma team activations in a single major Lithuanian trauma center: A retrospective single-center study. Int J Crit Illn Inj Sci 2022; 12:17-21. [PMID: 35433397 PMCID: PMC9008292 DOI: 10.4103/ijciis.ijciis_66_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 10/04/2021] [Accepted: 02/28/2022] [Indexed: 11/23/2022] Open
Abstract
Background: As a result of the coronavirus disease 2019 (COVID-19) pandemic and national quarantine, different levels of social and movement restrictions, and stay-at-home requests, trauma trends have changed. The aim of the present study was to determine the impact of lockdown on patients treated by the trauma team (TT) at a single major Lithuanian trauma center during the COVID-19 pandemic. Methods: This is a retrospective, descriptive study of adult (≥18 years old) trauma patients (for whom the TT was activated). Consequently, we analyzed the national lockdown periods from 16 March to 15 May 2020 and from 16 December 2020 to 28 February 2021, compared with the corresponding period of the previous year. Results: There was a 10% reduction in TT activations during the national lockdown period. No significant differences were noted in patient demographics. In the COVID-19 cohort, patients had higher Injury Severity Score (14 [IQR 6−21] vs. 9 [IQR 3−18], P = 0.025) and longer time to computed tomography scan (33 [IQR 25−43] vs. 23 [IQR 20−31] min, P < 0.001). Moreover, in the COVID-19 cohort, three times more patients were transferred from the emergency department (ED) straight to the operating room (n = 12 [19%] vs. n = 4 [5.7%], P = 0.018, Cramer's V = 0.21). Conclusion: Patients were more severely injured, and more patients required emergent surgery during the lockdown. In addition, it took longer to transfer patients to the ED and to perform a computed tomography scan.
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10
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Out-of-hospital cardiac arrest: prehospital physician's role during CPR should be clarified. Eur J Emerg Med 2021; 28:411-413. [PMID: 34714812 DOI: 10.1097/mej.0000000000000881] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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11
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Quirion A, Nikouline A, Jung J, Nolan B. Contemporary uses of trauma video review: a scoping review. CAN J EMERG MED 2021; 23:787-796. [PMID: 34453728 DOI: 10.1007/s43678-021-00178-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 07/19/2021] [Indexed: 12/17/2022]
Abstract
OBJECTIVES 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. METHODS Medline and Embase were searched from 1980 to May 2020 for studies involving trauma video review. English studies of adult and paediatric populations were included for study and analysed for uses of trauma video review, outcomes measured and any resulting quality improvement (QI) initiatives. RESULTS A total of 463 publications were identified with 21 studies meeting eligibility for final inclusion. A majority of studies (11) observed technical skills with analysis of critical procedures, including tracheal intubation and thoracotomy. The remaining studies observed team dynamics and communication. Overall, eight studies resulted in new policies being put in place for trauma resuscitations and six studies utilized trauma video review as an educational tool. CONCLUSIONS 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.
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Affiliation(s)
- Andrew Quirion
- Division of Emergency Medicine, Department of Medicine, University of Toronto, S517-112 George Street, Toronto, ON, M5A 2M5, Canada.
| | - Anton Nikouline
- Division of Emergency Medicine, Department of Medicine, University of Toronto, S517-112 George Street, Toronto, ON, M5A 2M5, Canada
| | - James Jung
- Department of Surgery, Massachusetts General Hospital, Boston, MA, USA.,International Centre for Surgical Safety, St. Michael's Hospital, Toronto, ON, Canada
| | - Brodie Nolan
- Division of Emergency Medicine, Department of Medicine, University of Toronto, S517-112 George Street, Toronto, ON, M5A 2M5, Canada.,International Centre for Surgical Safety, St. Michael's Hospital, Toronto, ON, Canada.,Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.,Department of Emergency Medicine, St. Michael's Hospital, Toronto, ON, Canada
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12
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October TW, Schell JO, Arnold RM. There Is No I in Team: Building Health Care Teams for Goals of Care Conversations. J Palliat Med 2021; 23:1002-1003. [PMID: 32790569 DOI: 10.1089/jpm.2020.0310] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Tessie W October
- Department of Critical Care, Children's National Hospital, Washington, DC, USA.,Department of Pediatrics, School of Medicine and Health Sciences, The George Washington University, Washington, DC, USA
| | - Jane O Schell
- Division of Renal-Electrolyte, University of Pittsburgh School of Medicine, UPMC Health System, Pittsburgh, Pennsylvania, USA.,Division of General Internal Medicine, Section of Palliative Care and Medical Ethics and Palliative Research Center (PaRC), University of Pittsburgh, Pennsylvania, USA
| | - Robert M Arnold
- Division of General Internal Medicine, Section of Palliative Care and Medical Ethics and Palliative Research Center (PaRC), University of Pittsburgh, Pennsylvania, USA
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