Related Experiment Video
Updated: Sep 18, 2025
Minimally Invasive Treatment for Thoracolumbar Burst Fracture Using Sagittal Alignment Screws and A Trauma Reduction Device
Published on: November 8, 2024
Impact of Trauma Team Census on Patients With Rib Fractures
Anthony J Duncan1, David R Velez1, Khaled Zreik2
1Department of Surgery, University of North Dakota School of Medicine and Health Sciences, Grand Forks, USA.
Background:
Workloads of healthcare professionals have continued to increase in recent years. With increased workload, some studies have shown increased length of stay for patients, higher cost, and higher risk of patient safety events. Trauma teams are a group that is particularly vulnerable to changes in patient census. This study aims to evaluate the impact of high versus low trauma team census on outcomes.
Methods:
A retrospective review of all rib fracture patients at a level I trauma center from 2017 to 2022 was conducted. The average daily census was determined, and high or low census days were assessed by being above or below this, respectively. The impact of census levels on outcomes was assessed using bivariate analysis and multivariate regression.
Results:
A total of 1,291 patients were included, with 663 admitted on high census days and 628 admitted on low census days. Demographics and comorbidities were similar between groups. Surgical fixation rates and time to surgery were similar between census levels. High census admissions had lower ICU admission rates (odds ratio (OR): 0.78, p=0.034) and higher delirium risk (OR: 3.21, p=0.005).
Conclusion:
Despite some seasonal variation between groups, patients admitted on high and low census days have similar demographics and prehospital comorbidities. However, patients admitted on high census days were less likely to receive ICU admission and had increased delirium rates, raising concerns about under-triage and emphasizing the need for improved resource allocation during high-volume periods.
Related Concept Videos
01:26Flail Chest-II
Assessment:
1. Clinical Evaluation:
History:
01:24Flail Chest-I
Flail chest is a severe and potentially life-threatening condition characterized by the fracture of three or more adjacent ribs in multiple places. It is most commonly caused by direct impacts and trauma, such as motor vehicle accidents or injuries from a steering wheel impact. It can also occur due to falls in elderly individuals with osteoporosis, or assaults involving sharp objects.
Pathophysiology
The pathophysiology of flail chest is complex, involving fractures of...
01:14SBAR II: Application of SBAR
SBAR Report from a Nurse to a Health Care Provider
S: "Hello, Dr. Smith. This is Jane, RN, from the Med Surg unit. I am calling to tell you about Ms. White in Room 210, who is experiencing increased pain and redness at her incision site. Her recent...
01:20The Thoracic Cage: Ribs
Parts of a Typical Rib
A typical rib has a head, neck, and body. The posterior end of the rib is called the head, followed by a narrow neck. The head articulates primarily with the costal...
01:27Fractures: Bone Repair
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the...
01:29Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care