College of Medicine, Nursing and Health Sciences, Fiji National University, Suva, Fiji.
West Gippsland Healthcare Group, Melbourne, Victoria, Australia.
Emerg Med Australas. 2019 Aug;31(4):654-658. doi: 10.1111/1742-6723.13225. Epub 2019 Jan 28.
The trauma team process was recently implemented at the Colonial War Memorial (CWM) Hospital, Suva. This study audits the trauma call procedure at the hospital over a period of 12 months.
Retrospective descriptive study of trauma calls from August 2015 to July 2016 at CWM Hospital. Data relating to patient demographics, time of presentation, time to team assembly and time to computed tomography (CT) scan were extracted from the ED trauma call database. Disposition from the ED and status at hospital discharge was extracted from the hospital patient information system.
There were 38 trauma calls for 46 patients. Seventy-two per cent were male. Eighty-two per cent occurred when the CT radiographer was off site (16.00-08.00 h), including 47% that occurred between midnight and 08.00 h. Fifty-two per cent of patients were intubated, 43% went to ICU, 26% went directly to the operating theatre, and 37% died. Benchmarks for time to trauma team assembly and time to CT scan were met in 50% of cases.
This was a severely injured cohort of patients with a high mortality rate. The rate of missed calls was not assessed in this study. Time to CT scan could be improved with an onsite radiographer. Time to team assembly could be improved with trauma team training and early notification from pre-hospital providers. There is a need to continue to monitor and refine the trauma call process and to extend data capture to measure injury severity and outcomes.
创伤团队流程最近在苏瓦的殖民地战争纪念医院（CWM）实施。本研究对该医院在 12 个月期间的创伤呼叫程序进行了审核。
对 2015 年 8 月至 2016 年 7 月 CWM 医院的创伤呼叫进行回顾性描述性研究。从急诊创伤呼叫数据库中提取与患者人口统计学、就诊时间、团队组建时间和计算机断层扫描（CT）时间相关的数据。从医院患者信息系统中提取急诊科的处置情况和出院时的状态。
共发生 38 次创伤呼叫，涉及 46 名患者。72%为男性。82%的呼叫发生在 CT 放射技师不在场时（16.00-08.00 小时），包括 47%发生在午夜至 08.00 小时之间。52%的患者进行了插管，43%进入 ICU，26%直接进入手术室，37%死亡。50%的病例达到了创伤团队组建时间和 CT 扫描时间的基准。
这是一组严重受伤的患者，死亡率很高。本研究未评估错过呼叫的发生率。如果有现场放射技师，CT 扫描时间可以得到改善。通过创伤团队培训和院前提供者的早期通知，可以改善团队组建时间。需要继续监测和完善创伤呼叫流程，并扩大数据采集范围，以衡量伤害严重程度和结果。
