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Association Between Prearrival Notification Time and Advanced Trauma Life Support Protocol Adherence

Omar Z Ahmed1, Sen Yang2, Richard A Farneth1

  • 1Children's National Medical Center, Division of Trauma and Burn Surgery, Washington, District of Columbia.

The Journal of Surgical Research
|May 18, 2019
PubMed

Insights

Timely prearrival notification significantly improves adherence to Advanced Trauma Life Support (ATLS) protocols for injured patients. Shorter notification times, especially under 5-10 minutes, diminish performance, necessitating improved strategies.

Area of Science:

  • Emergency Medicine
  • Trauma Care
  • Clinical Process Improvement

Background:

  • Prearrival notification is crucial for optimizing trauma care preparation.
  • Effective preparation ensures necessary personnel, equipment, and resources are available for timely evaluation and treatment.
  • Adherence to established protocols like Advanced Trauma Life Support (ATLS) is vital for optimal patient outcomes.

Purpose of the Study:

  • To evaluate the impact of prearrival notification duration on adherence to ATLS protocols in pediatric trauma cases.
  • To quantify the relationship between notification time and the quality of trauma resuscitation activities.

Main Methods:

  • Video review of pediatric trauma activations to assess pre- and post-arrival activities.
  • Development of an expert model based on ATLS to calculate adherence "fitness scores" (0-100).
  • Multivariate regression analysis to correlate fitness scores with notification time and injury severity.

Main Results:

  • Longer prearrival notification times correlated with better performance in prearrival tasks, overall resuscitation, and secondary surveys.
  • The positive association between notification time and performance weakened significantly with notification times less than 5-10 minutes.
  • Notification time was positively correlated with the availability of required team members upon patient arrival (r=0.46, P<0.001).

Conclusions:

  • Prearrival notification time critically influences adherence to ATLS protocols.
  • Strategies to enhance notification timeliness or improve performance during brief notification periods are essential.
  • Optimizing prearrival communication is key to improving trauma care quality.
Abstract

Keywords:
ATLS performancePediatric traumaPrearrival notification timeTrauma resuscitation errors

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