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Interfacility Transfer Guidelines for Isolated Facial Trauma: A Multidisciplinary Expert Consensus
Matthew E Pontell1, Jordan P Steinberg1, Donald R Mackay1
1From the Department of Plastic Surgery and Department of Medical Bioinformatics, Center for Biomedical Ethics and Society, Vanderbilt University Medical Center; Departments of Plastic and Reconstructive Surgery and Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine; Division of Plastic Surgery, Penn State Health Milton S. Hershey Medical Center; Hansjörg Wyss Department of Plastic Surgery, New York University Langone Health; Department of Otolaryngology-Head and Neck Surgery, University of California, Davis; Department Otolaryngology-Head and Neck Surgery, Division of Oral and Maxillofacial Surgery, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital, Northwestern Memorial Hospital; Department of Otolaryngology-Head and Neck Surgery, Division of Facial Plastic and Reconstructive Surgery, University of Kansas Medical Center; Division of Pediatric Plastic Surgery, Division of Cleft and Craniofacial Surgery, Monroe Carell Jr. Children's Hospital at Vanderbilt; Department of Oral and Maxillofacial Surgery, University of Pittsburgh Medical Center; Department of Plastic and Reconstructive Surgery, Icahn School of Medicine at Mount Sinai; Division of Oral and Maxillofacial Surgery, Loyola University Medical Center; Craniofacial Center at Seattle Children's Hospital, University of Washington Harborview Medical Center; and Department of Plastic and Hand Surgery, Regionals Hospital, University of Minnesota Medical Center.
New guidelines aim to improve craniomaxillofacial trauma patient transfers. Developed by experts, these guidelines help streamline care for facial trauma, reducing costs and improving emergency medical services.
Area of Science:
- Trauma Surgery
- Plastic Surgery
- Oral and Maxillofacial Surgery
Background:
- Craniomaxillofacial trauma requires complex transfer decisions.
- Overtriage of trauma patients can strain resources and delay care.
Purpose of the Study:
- To develop evidence-based guidelines for transferring patients with isolated craniomaxillofacial trauma.
- To standardize the management of facial trauma cases.
Main Methods:
- A national multidisciplinary expert panel was convened.
- The modified Delphi process was used to collect expert opinions.
- Consensus was defined as 90% agreement on transfer guidelines.
Main Results:
- Thirteen transfer guidelines were established after four consensus rounds.
- Twelve guidelines achieved the predefined consensus level.
- Guidelines cover fractures of the frontal sinus, orbit, midface, mandible, and soft-tissue injuries.
Conclusions:
- The developed guidelines serve as a tool to improve and streamline care for facial trauma patients.
- Implementing these guidelines can decrease healthcare expenditures associated with overtriage.
- These guidelines aim to decompress emergency medical systems and tertiary emergency departments.
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