UK-wide major trauma center tertiary trauma survey pro forma review and aggregation and consolidation into a redesigned document
Objectives The trauma tertiary survey (TTS) is an essential part of the continued care for major trauma patients which is performed to ensure that all injuries have been identified and none have been overlooked during the patient’s stay. Although the Advanced Trauma Life Support Course states a need...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2023-11-01
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| Series: | Trauma Surgery & Acute Care Open |
| Online Access: | https://tsaco.bmj.com/content/8/1/e000903.full |
| _version_ | 1797367285803909120 |
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| author | Mark Parson Lisa Rampersad Adam Pickard Dan Simpson Michael Treece |
| author_facet | Mark Parson Lisa Rampersad Adam Pickard Dan Simpson Michael Treece |
| author_sort | Mark Parson |
| collection | DOAJ |
| description | Objectives The trauma tertiary survey (TTS) is an essential part of the continued care for major trauma patients which is performed to ensure that all injuries have been identified and none have been overlooked during the patient’s stay. Although the Advanced Trauma Life Support Course states a need for a tertiary survey, there is currently no standard for what this survey comprises.Methods Using local consultant expert opinion and a literature search we identified a set of 32 TTS potential features that may be included within a TTS pro forma. Major trauma center (MTC) documents were requested from every MTC within the UK. 4 investigators sequentially interrogated each MTC TTS document looking for (1) presence of each feature and (2) how well the feature was represented on the document (0 to 4 Likert Scale). Any previously unidentified potential TTS features were noted and later reviewed for a second round of document analysis.Results A total of 21 out of all 26 UK MTCs had a TTS pro forma document. A total of 68 possible features were identified. Respiratory and Abdominal assessment sections were the most frequently identified features (present in 90.4% of the TTS pro formas; n=19. Neck assessment and neurological assessment were included within 85.7% of the TTS pro formas (n=18). Further aspects identified for Round 2 analysis typically included features that were thought to be important but highly specific. For example, pregnancy test and DNACPR discussions were found in 1 MTC TTS each (4%).Conclusion This article presents a review of the existing documents at 21 MTCs in the UK, identification of features used and proposes a gold standard TTS which can be used by any doctor to perform the tertiary survey and reduce the risk of missed injuries in trauma patients.Level of Evidence 3. |
| first_indexed | 2024-03-08T17:16:06Z |
| format | Article |
| id | doaj.art-be5aba891deb4fc7bc9dd7e3ebc9aeae |
| institution | Directory Open Access Journal |
| issn | 2397-5776 |
| language | English |
| last_indexed | 2024-03-08T17:16:06Z |
| publishDate | 2023-11-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | Trauma Surgery & Acute Care Open |
| spelling | doaj.art-be5aba891deb4fc7bc9dd7e3ebc9aeae2024-01-03T13:25:07ZengBMJ Publishing GroupTrauma Surgery & Acute Care Open2397-57762023-11-018110.1136/tsaco-2022-000903UK-wide major trauma center tertiary trauma survey pro forma review and aggregation and consolidation into a redesigned documentMark Parson0Lisa Rampersad1Adam Pickard2Dan Simpson3Michael Treece4Anaesthetics, Royal Sussex County Hospital, Brighton, UKSurgery, Royal Sussex County Hospital, Brighton, UKIntensive Care Medicine, Royal Sussex County Hospital, Brighton, UKIntensive Care Medicine, Royal Sussex County Hospital, Brighton, UKEmergency Department, Medway Maritime Hospital, Gillingham, UKObjectives The trauma tertiary survey (TTS) is an essential part of the continued care for major trauma patients which is performed to ensure that all injuries have been identified and none have been overlooked during the patient’s stay. Although the Advanced Trauma Life Support Course states a need for a tertiary survey, there is currently no standard for what this survey comprises.Methods Using local consultant expert opinion and a literature search we identified a set of 32 TTS potential features that may be included within a TTS pro forma. Major trauma center (MTC) documents were requested from every MTC within the UK. 4 investigators sequentially interrogated each MTC TTS document looking for (1) presence of each feature and (2) how well the feature was represented on the document (0 to 4 Likert Scale). Any previously unidentified potential TTS features were noted and later reviewed for a second round of document analysis.Results A total of 21 out of all 26 UK MTCs had a TTS pro forma document. A total of 68 possible features were identified. Respiratory and Abdominal assessment sections were the most frequently identified features (present in 90.4% of the TTS pro formas; n=19. Neck assessment and neurological assessment were included within 85.7% of the TTS pro formas (n=18). Further aspects identified for Round 2 analysis typically included features that were thought to be important but highly specific. For example, pregnancy test and DNACPR discussions were found in 1 MTC TTS each (4%).Conclusion This article presents a review of the existing documents at 21 MTCs in the UK, identification of features used and proposes a gold standard TTS which can be used by any doctor to perform the tertiary survey and reduce the risk of missed injuries in trauma patients.Level of Evidence 3.https://tsaco.bmj.com/content/8/1/e000903.full |
| spellingShingle | Mark Parson Lisa Rampersad Adam Pickard Dan Simpson Michael Treece UK-wide major trauma center tertiary trauma survey pro forma review and aggregation and consolidation into a redesigned document Trauma Surgery & Acute Care Open |
| title | UK-wide major trauma center tertiary trauma survey pro forma review and aggregation and consolidation into a redesigned document |
| title_full | UK-wide major trauma center tertiary trauma survey pro forma review and aggregation and consolidation into a redesigned document |
| title_fullStr | UK-wide major trauma center tertiary trauma survey pro forma review and aggregation and consolidation into a redesigned document |
| title_full_unstemmed | UK-wide major trauma center tertiary trauma survey pro forma review and aggregation and consolidation into a redesigned document |
| title_short | UK-wide major trauma center tertiary trauma survey pro forma review and aggregation and consolidation into a redesigned document |
| title_sort | uk wide major trauma center tertiary trauma survey pro forma review and aggregation and consolidation into a redesigned document |
| url | https://tsaco.bmj.com/content/8/1/e000903.full |
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