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Is operating room resuscitation a way to save time?
J T Steele1, D B Hoyt, R K Simons
1Department of Surgery, University of California at San Diego, USA.
American Journal of Surgery
|December 31, 1997
Summary
Direct operating room (OR) resuscitation effectively identifies critically injured patients. This protocol shortens time to incision for trauma patients, improving survival rates through timely surgical intervention.
Area of Science:
- Trauma Surgery
- Emergency Medicine
- Surgical Critical Care
Background:
- Direct operating room (OR) admission can reduce time to incision.
- A protocol for OR resuscitation was developed.
- Triage criteria included cardiac arrest, refractory hypotension, and uncontrolled hemorrhage.
Purpose of the Study:
- To evaluate the accuracy of triage criteria for identifying patients needing immediate operation.
- To assess the impact of OR resuscitation on patient outcomes.
- To compare observed survival with predicted survival.
Main Methods:
- Retrospective review of 11 years of OR resuscitation cases.
- Analysis of patient triage based on established criteria.
- Comparison of survival rates with scene-based probability of survival.
Main Results:
- Patients undergoing OR resuscitation were more likely to require major operations.
- 146 of 170 patients (85.9%) with penetrating trauma and hypotension required major surgery.
- Time to incision was reduced by 21.7-67.5 minutes for patients receiving OR resuscitation.
Conclusions:
- Field triage criteria reliably identify patients needing immediate major operative intervention.
- Direct OR admission facilitates timely surgical procedures for critically injured patients.
- This approach improves the initiation of emergency surgical care.