Paramedic and Surgeon Views on Trauma Surgical Readiness: Implications for Guideline Implementation

Area of Science:

• Emergency Medicine
• Trauma Surgery
• Public Health Policy

Background:

• Centers for Disease Control (CDC) Guidelines for Field Triage require EMS and surgeon collaboration for effectiveness.
• Immature trauma systems may present challenges in aligning EMS and surgeon perceptions of readiness.
• Discrepancies in perceived surgical readiness can lead to inconsistent protocol implementation.

Purpose of the Study:

• To investigate the discrepancy between medic and surgeon perceptions of surgical readiness in a rural state.
• To assess the impact of trauma system immaturity on the implementation of CDC field triage guidelines.
• To identify factors influencing medic and surgeon decision-making in trauma patient destination.

Main Methods:

• Surveys administered to EMS personnel (medics) and general surgeons.
• Assessment of destination protocols, trauma center proximity, and surgeon willingness/interest in trauma care.
• Evaluation using a standard clinical trauma scenario.

Main Results:

• Surgeon willingness to operate is independent of their practice location or interest in trauma.
• Medics located farther from trauma centers report lower confidence in local surgeon willingness and less adherence to destination protocols.
• Trauma center proximity influences medic perception of surgeon willingness, but not the mere presence of surgeons.

Conclusions:

• A significant disparity exists between surgeon willingness to operate and medic perception of this willingness in rural settings.
• This perception gap contributes to inconsistent application of CDC field triage guidelines, with some patients bypassing appropriate trauma centers.
• Enhancing medic training, surgeon readiness, and aligning goals are crucial for effective CDC guideline implementation.