Succar Bahaa, Lunardi Nicole, Gopal Kaustubh, Afsari Macy, Nagaraj Madhuri B, Zeh Herbert J, Dumas Ryan P
Department of Surgery, Division of Burns, Trauma, and Acute Care Surgery, University of Texas Southwestern, Dallas, TX, USA.
Department of Surgery, Division of Trauma and Acute Care Surgery, Baylor College of Medicine, Houston, TX, USA.
Am J Surg. 2025 Feb;240:116121. doi: 10.1016/j.amjsurg.2024.116121. Epub 2024 Nov 28.
Trauma team performance, measured by the non-technical skills scale T-NOTECHS, has been shown to impact patient outcomes. We assess how personnel movements affect non-technical skills and time of resuscitation(TOR) using trauma video review.
A prospective study of blunt and/or penetrating trauma activations recorded between May and November 2023 at a Level-I trauma center. Regressions controlling for confounders were used to measure the association between foot traffic and the outcomes of interest: TOR T-NOTECHS score(Smith et al., 2015; Mackenzie et al., 2007; Maiga et al., 2024; Vella et al., 2024; Pucher et al., 2014; Dumas et al., 2020; Succar et al., 2024; Steinemann et al., 2012; Andersson et al., 2012; Conrad et al., 2010; Lies and Zhang, 2015) .5-155-15 RESULTS: We identified 77 trauma activations, with 40 %(n = 32/77) penetrating injuries. There was a median of 17[14-18] individuals at the start of trauma activations. During resuscitations, individuals entered the room a median of 12[8-18] times and exited the room 17[11-22] times. The median TOR was 8[6-10] min and the median T-NOTECHS was 7[6-8]. Regression analysis showed foot traffic was independently associated with increased TOR(β 0.34, p-value <0.01) and worse total T-NOTECHS score(β 0.06, p < 0.01).
Higher foot traffic is associated with poorer team performance and delays in resuscitation. Future directions should further explore environmental and personal factors that may impede performance metrics.
通过非技术技能量表T-NOTECHS衡量的创伤团队表现已被证明会影响患者的治疗结果。我们使用创伤视频回顾来评估人员流动如何影响非技术技能和复苏时间（TOR）。
对2023年5月至11月期间在一级创伤中心记录的钝性和/或穿透性创伤激活情况进行前瞻性研究。使用控制混杂因素的回归分析来衡量人员流动与感兴趣的结果之间的关联：TOR、T-NOTECHS评分（史密斯等人，2015年；麦肯齐等人，2007年；马伊加等人，2024年；韦拉等人，2024年；普赫尔等人，2014年；杜马斯等人，2020年；苏卡尔等人，2024年；施泰内曼等人，2012年；安德森等人，2012年；康拉德等人，2010年；利斯和张，2015年）。5 - 155 - 15结果：我们确定了77次创伤激活事件，其中40%（n = 32/77）为穿透性损伤。创伤激活开始时的人员中位数为17[14 - 18]人。在复苏过程中，人员进入房间的中位数为12[8 - 18]次，离开房间的中位数为17[11 - 22]次。TOR的中位数为8[6 - 10]分钟，T-NOTECHS的中位数为7[6 - 8]。回归分析表明，人员流动与TOR增加（β 0.34，p值<0.01）和总T-NOTECHS评分较差（β 0.06，p < 0.01）独立相关。
人员流动量越大，团队表现越差，复苏延迟越严重。未来的研究方向应进一步探索可能阻碍绩效指标的环境和个人因素。
