Binstead, Justin, DO

Fischer, Catherine, DO

Gerrald, Quincy, DO

Kane, Bryan G, MD

Sibley, Mary, DO

Vong, Kevin, DO

English

Lehigh Valley Health Network: LVHN Scholarly Works

Lehigh Valley Health NetworkLVHN Scholarly WorksDepartment of Emergency MedicineA Statewide Survey of Institutional Trauma HumanResource Allocation and Associated PatientMortalityBryan G. Kane MDLehigh Valley Health Network, bryan.kane@lvhn.orgQuincy Gerrald DOLehigh Valley Health NetworkCatherine Fischer DOLehigh Valley Health Network, Catherine_B.Fischer@lvhn.orgKevin Vong DOLehigh Valley Health NetworkMary Sibley DOLehigh Valley Health NetworkSee next page for additional authorsFollow this and additional works at: https://scholarlyworks.lvhn.org/emergency-medicinePart of the Emergency Medicine Commons, Statistics and Probability Commons, and theTrauma CommonsThis Poster is brought to you for free and open access by LVHN Scholarly Works. It has been accepted for inclusion in LVHN Scholarly Works by anauthorized administrator. For more information, please contact LibraryServices@lvhn.org.Published In/Presented AtKane, B., Gerrald, Q., Fischer, C., Vong, K., Sibley, M., & Binstead, J. (2014, February 22). A statewide survey of instiutional traumahuman resource allocation and associated patient mortality. Poster presented at: The 2014 Society of Academic Emergency Medicine(SAEM) Mid-Atlantic Regional Meeting, Philadelphia, PA.AuthorsBryan G. Kane MD, Quincy Gerrald DO, Catherine Fischer DO, Kevin Vong DO, Mary Sibley DO, and JustinBinstead DOThis poster is available at LVHN Scholarly Works: https://scholarlyworks.lvhn.org/emergency-medicine/250Lehigh Valley Health Network, Allentown, PennsylvaniaA Statewide Survey of Institutional Trauma Human Resource Allocation and Associated Patient MortalityBryan G. Kane, MD, Quincy Gerrald, DO, Catherine Fischer, DO, Kevin Vong, DO, Mary Sibley, DO, Justin Binstead, DOIntroduction:© 2014 Lehigh Valley Health NetworkExcellent trauma care relies on an excellent trauma system. It requires a coordinated, multidisciplinary approach to the care of the victim. As it relates to patient mortality, who should comprise that multidisciplinary team and the criteria to activate it has not been well described. Study Objectives:In this study, we sought to determine the allocation of trauma staff who respond to an injured trauma patient in trauma centers across the State of Pennsylvania (PA) for differing triage levels. We also sought the initial mortality data for trauma activated patients.Methods:After IRB approval, statewide data were gathered from trauma centers through the Pennsylvania State Trauma Systems Foundation (PTSF). PTSF maintains records of resource allocation as part of the application and renewal process for trauma accreditation. Anonymous institutional data collected included all personnel who respond to trauma I codes (highest level of activation), trauma II codes, and trauma consults (non-trauma activated patients). Patient outcome data from each institution were also included. Data included were for the calendar year 2008.Results:PTSF provided data on 32 certified trauma centers. Statistically significant differences were noted in the distribution of the staff required to respond to different trauma triage levels, with the trauma I activation more likely to have anesthesia, a trauma surgeon, CRNA, respiratory therapy and blood bank (all p<0.001) than trauma II or consults. Other staff with p<0.05 more likely to respond to trauma I were OR RN, ICU RN, RN director, OR physicians, security and social work. ED physicians were less likely to respond to trauma I (p=0.23). Figure 1 depicts that there is no linear relationship between ISS score and mortality in the ED.Conclusion:Within PA, there is a statistically significant difference in the number of staff resources applied to trauma patients at different levels of trauma response activation. No clear linear relationship between severity of injury and mortality was found. This raises the issue of whether the mortality differences between institutions are based on the proper activation of the trauma response system. If so, more attention needs to be placed on trauma center patient triage criteria.Figure 1.  Scatterplot of Injury Severity Score (ISS) and the proportion of patients who died in the Emergency Department of the presenting institution with smoothed Lowess curve.54321Proportion of Cases Who Died (%)0024681012InjurySeverityScore(ISS)14161820Funding: Funding for this project was provided, in part, by a PCOM MEDNet unrestricted research grant.

A Statewide Survey of Institutional Trauma Human Resource Allocation and Associated Patient Mortality

https://scholarlyworks.lvhn.org/cgi/viewcontent.cgi?article=1249&context=emergency-medicine

A Statewide Survey of Institutional Trauma Human Resource Allocation and Associated Patient Mortality

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