Direct to Operating Room Resuscitation-A Regional Practice Survey

Area of Science:

• Trauma Surgery
• Surgical Critical Care
• Emergency Medicine

Background:

• Direct-to-operating room resuscitation (DOR) bypasses the emergency department for trauma patients.
• Retrospective studies suggest potential benefits for select patients.
• Utilization and practice patterns of DOR are not well-documented.

Purpose of the Study:

• To assess the prevalence of DOR in New England trauma centers.
• To characterize regional DOR utilization and practice patterns.

Main Methods:

• A web-based survey was sent to all New England level I and II trauma centers.
• The survey collected data on hospital characteristics, DOR utilization, activation criteria, indications, and protocols.
• Descriptive statistics and thematic analysis were used.

Main Results:

• All 23 trauma centers responded (100% response rate).
• 57% of centers (13/23) reported performing DOR, with a median of 2 activations annually.
• Most centers lacked standardized inclusion criteria, activation processes, or post-arrival assessment protocols.

Conclusions:

• DOR is infrequently utilized in New England and often performed ad hoc.
• Standardized activation criteria and in-operating room evaluation processes are needed.
• Further research is warranted to understand national DOR practices.