Standardizing the initial resuscitation of the trauma patient with the Primary Assessment Completion Tool using video review

Wurster, Lee Ann; Thakkar, Rajan K.; Haley, Kathy; Wheeler, Krista K.; Larson, Jeremy T.; Stoner, Michael J.; Gewirtz, Yaffa; Holman, Todd; Buckingham, Don; Groner, Jonathan I.

doi:10.1097/ta.0000000000001417

Cited by 13 publications

(14 citation statements)

References 11 publications

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“…In such circumstances, providers charged with data collection may be unable to accurately ascertain precise nature, timing and details of events occurring during resuscitation. High-fidelity audiovisual recording of injury resuscitation captures all events in a time-stamped fashion allowing for extremely granular evaluation of care processes and performance (9) (18) (19). Audio recording provides supporting data addressing intra-team communication and critical loop closure, essential elements in assessing team leader performance and the timing of recognition of key changes in condition.…”

Section: Discussionmentioning

confidence: 99%

The intraosseous have it: A prospective observational study of vascular access success rates in patients in extremis using video review

Chreiman¹,

Dumas

Seamon

et al. 2018

J Trauma Acute Care Surg

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Section: Discussionmentioning

confidence: 99%

The intraosseous have it: A prospective observational study of vascular access success rates in patients in extremis using video review

Chreiman¹,

Dumas

Seamon

et al. 2018

J Trauma Acute Care Surg

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“…There are many inefficiencies that occur during the course of a trauma activation that contribute to prolonged times in the trauma bay [ 4 , 5 ]. Furthermore, there is significant data that shows, both objectively and subjectively, that video review can improve the quality of trauma resuscitations [ 4 - 6 ]. While our study was not designed to look at patient level outcomes, the decrease in time spent in the trauma bay likely lead to improved patient care by streamlining the trauma resuscitation.…”

Section: Discussionmentioning

confidence: 99%

“…While medical team participants in video review report provider anxiety as the main adverse effect of conducting video review, the vast majority of participants feel that it provides significant educational value [ 3 ]. Video review in trauma has been shown to improve trauma team function, identify and decrease errors during trauma resuscitation, and increase compliance to Advanced Trauma Life Support (ATLS) protocols [ 4 - 6 ].…”

Section: Introductionmentioning

confidence: 99%

Established Time Goals Can Increase the Efficiency of Trauma Resuscitation

Taylor

Hewes

Bolinger

et al. 2020

Cureus

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“…Similar QI projects have revealed that standardization can improve care in the most stressful and acute environments. 23 Wurster et al 23 used QI methodology to improve compliance with advanced trauma life support recommendations for the primary assessment of trauma patients. Hunt et al 24 instituted a resuscitation quality bundle and demonstrated improved adherence to AHA CPR guidelines for pediatric inhospital cardiac arrest.…”

Section: Discussionmentioning

confidence: 99%

Enhancing CPR During Transition From Prehospital to Emergency Department: A QI Initiative

Hoehn

Cabrera-Thurman²,

Oehler

et al. 2020

Pediatrics

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BACKGROUND AND OBJECTIVES: High-quality cardiopulmonary resuscitation (CPR) increases the likelihood of survival of pediatric out-of-hospital cardiac arrest (OHCA). Maintenance of high-quality CPR during transition of care between prehospital and pediatric emergency department (PED) providers is challenging. Our objective for this initiative was to minimize pauses in compressions, in alignment with American Heart Association recommendations, for patients with OHCA during the handoffs from prehospital to PED providers. We aimed to decrease interruptions in compressions during the first 2 minutes of PED care from 17 seconds (baseline data) to 10 seconds over 12 months. Our secondary aims were to decrease the length of the longest pause in compressions to ,10 seconds and eliminate encounters in which time to defibrillator pad placement was .120 seconds.METHODS: Our multidisciplinary team outlined our theory for improvement and designed interventions aimed at key drivers. Interventions included specific roles and responsibilities, CPR handoff choreography, and empowerment of frontline providers. Data were abstracted from video recordings of patients with OHCA receiving manual CPR on arrival. RESULTS:We analyzed 33 encounters between March 2018 and July 2019. We decreased total interruptions from 17 to 12 seconds during the first 2 minutes and decreased the time of the longest single pause from 14 to 7 seconds. We saw a decrease in variability of time to defibrillator pad placement.CONCLUSIONS: Implementation of a quality improvement initiative involving CPR transition choreography resulted in decreased interruptions in compressions and decreased variability of time to defibrillator pad placement.Survival in pediatric out-of-hospital cardiac arrest (OHCA) is low, with published estimates of 10.2%. 1 Multiple studies reveal that highquality cardiopulmonary resuscitation (CPR) in OHCA increases the likelihood of return of spontaneous circulation and favorable neurologic outcomes. [2][3][4][5] The 2015 American Heart Association (AHA) defines high-quality CPR by 5 components: (1) adequate frequency, (2) adequate depth, (3) allowing full chest recoil, (4) minimizing interruptions in compressions, and (5) avoidance of excessive ventilation. 6 Animal studies demonstrate that interruptions in chest compression decrease coronary and cerebral blood flow. 7 The AHA recommends compression pauses to be

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Standardizing the initial resuscitation of the trauma patient with the Primary Assessment Completion Tool using video review

Abstract: Therapeutic/care management study, level IV.

Cited by 13 publications

References 11 publications

The intraosseous have it: A prospective observational study of vascular access success rates in patients in extremis using video review

The intraosseous have it: A prospective observational study of vascular access success rates in patients in extremis using video review

Established Time Goals Can Increase the Efficiency of Trauma Resuscitation

Enhancing CPR During Transition From Prehospital to Emergency Department: A QI Initiative

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