Compliance with the European trauma guidelines: An observational single centre study.

Area of Science:

• Trauma Care
• Clinical Guidelines
• Patient Management

Background:

• European trauma guidelines aim to standardize early trauma care, focusing on coagulopathy and bleeding.
• Compliance with these guidelines is crucial for improving patient outcomes in trauma centers.

Purpose of the Study:

• To assess adherence to European trauma guidelines in a French referral trauma center.
• To identify areas of good compliance and areas needing improvement in trauma patient management.

Main Methods:

• Retrospective review of medical charts for trauma patients (Injury Severity Score ≥16).
• Assessment of compliance with 21 specific recommendations within the first 24 hours of admission.

Main Results:

• Nine out of 21 recommendations showed good compliance (≥80%).
• Inconsistent compliance (50-79%) was noted for six recommendations, including fibrinogen levels and mean arterial pressure targets.
• Poor compliance (<50%) was observed for early lactate measurement, tranexamic acid administration, and normocapnia in TBI patients.

Conclusions:

• While some European trauma guidelines are well-implemented, significant improvements are needed in early coagulopathy diagnosis and treatment.
• Specific focus is required on achieving target mean arterial pressure and maintaining normocapnia in traumatic brain injury (TBI) patients.