Medical College of Wisconsin
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Trauma team size and task performance in adult trauma resuscitations. J Surg Res 2016 07;204(1):176-82

Date

07/28/2016

Pubmed ID

27451884

DOI

10.1016/j.jss.2016.05.007

Abstract

BACKGROUND: The initial evaluation of a trauma patient involves multiple personnel from various disciplines. Whereas this approach can expedite care, an increasing number of personnel can also create chaos and hinder efficiency. We sought to determine the optimal number of persons associated with an expedient primary survey.

METHODS: Audio and/or video recordings of all consecutive adult trauma evaluations at a level 1 trauma center were reviewed for a 1-month period. A 20-task checklist was developed based on Advanced Trauma Life Support principles. The number of practitioners present (TeamN) and tasks completed at 2 and 5 min (Task2, Task5) were recorded. The association between TeamN, demographics, presence of attending surgeon, and team leader engagement and Task2/Task5 was measured the using chi square test and Spearman correlation. A multivariate regression model was developed.

RESULTS: A total of 170 cases were reviewed, 44 of which were top-tier activations. Average TeamN was 6 ± 2 persons. Task2 and Task5 were significantly positively correlated with TeamN (r = 0.34, P < 0.0001; r = 0.22, P = 0.004, respectively) and leader engagement (r = 0.27, P < 0.01; r = 0.16, P < 0.05, respectively). There was a significant positive correlation between TeamN and Task2 and Task5. Only TeamN had a significant, independent association with Task2 and Task5 (P = 0.005). We did not find a size that was negatively associated with task completion. Only assessment of breath sounds was negatively associated with increasing team size.

CONCLUSIONS: TeamN is significantly associated with efficiency of trauma evaluation. Studies evaluating reasons for this and the effect of maximal team size are needed to determine optimal trauma team staffing.

Author List

Maluso P, Hernandez M, Amdur RL, Collins L, Schroeder ME, Sarani B

Author

Mary Elizabeth Schroeder MD Assistant Professor in the Surgery department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adult
Checklist
District of Columbia
Efficiency, Organizational
Humans
Leadership
Multivariate Analysis
Patient Care Team
Resuscitation
Tape Recording
Task Performance and Analysis
Trauma Centers
Video Recording
Wounds and Injuries
jenkins-FCD Prod-468 69a93cef3257f26b866d455c1d2b2d0f28382f14