P053: Adverse events and errors in trauma resuscitation: a systematic review

Abstract

Introduction: Trauma resuscitations are plagued with high stress and require time sensitive and intensive interventions. It is a landscape that is a perfect hot bed for clinical errors and adverse events for patients. We sought to describe the adverse events and errors that occur during trauma resuscitation and any associated outcomes. Methods: Medline was searched for a combination of key terms involving trauma resuscitation, adverse events and errors from January 2000 to May 2019. Studies that described adverse events or errors in initial adult trauma resuscitations were included. Two reviewers analyzed papers for inclusion and exclusion criteria with a third reviewer for any discrepancies. Descriptions of errors, adverse events and associated outcomes were collated and presented. Results: A total of 3,462 papers were identified by our search strategy. 18 papers met our inclusion and exclusion criteria and were selected for full review. Adverse events and errors reported in trauma resuscitation included missed injuries, aspiration, failed airway, and deviation from protocol. Rates of adverse events and errors were reported where applicable. Mortality outcomes or length of stay were not directly correlated to adverse events or errors experienced in the trauma resuscitation. Conclusion: Our study highlights the predominance of adverse events and errors experienced during initial trauma resuscitation. We described a multitude of adverse events and errors and their rates but further study is needed to determine outcome differences for patients and possibility for quality improvement.