Article Figures & Data
Figures
- Figure 1
Patient flow during pit stop (PS) implementation. ED, emergency department.
Tables
- Table 1
Institutional major and minor trauma team activation and TR criteria
Major trauma activation criteria Minor trauma activation criteria Trauma resource criteria GCS score <13 Ejection from/off a vehicle EMS provider judgment SBP <90 Vehicle roll-over with unrestrained patient Age <5 or >55 years Respiratory rate <10 or >29 Death in the same passenger compartment Pregnancy >20 weeks Respiratory compromising or in need of emergent airway Auto vs. bicyclist/pedestrian thrown, run over, or with significant >20 mph impact Bleeding disorders Respiratory compromising or in need of emergent airway Fall >3 times the patient’s height or >15 feet Anticoagulant or antiplatelet agent use (exception: aspirin) Intubated patients transferred from the scene Exposure to blast or explosion Severe cardiac and/or respiratory disease Possible airway compromise Motorcycle crash >20 mph: ED physician or MICN judgment Loss of consciousness All penetrating injuries to the head, neck, torso or extremities proximal to the elbow/knee Amputations proximal to wrist/ankle End-stage renal disease requiring dialysis Two or more proximal long bone fractures Suspected pelvic fractures Extrication time >20 min Combative Limb paralysis Intrusion into occupied passenger space >12 inch frontal Transfer patients receiving blood to maintain vital signs Crush injury, degloved or mangled extremity Intrusion into occupied passenger space >8 inch side Flail chest Neurologic or vascular deficit to extremities Combination of trauma with burns Child abuse: known or suspected with significant injury ED, emergency department; EMS, emergency medical service; GCS, Glasgow Coma Scale; SBP, systolic blood pressure; TR, trauma resource.
- Table 2
Resource utilization by level of trauma activation*
Staff Major trauma Minor trauma Trauma resource Trauma surgeon X X As needed ED physician X X X Trauma nurse X X X Trauma scribe X X – Trauma support nurse X – – Respiratory therapist X Notified Notified Radiology technician X X Notified OR nurse X – – Phlebotomist X X Notified Blood bank X – – Activation charge $22 712 $20 031 $4879 *X denotes the presence of the staff member at the time of patient arrival.
ED, emergency department; OR, operating room.
- Table 3
Patient characteristics of TA vs. TR vs. non-TR consults after pit stop implementation
Trauma activations Trauma resources Non-TR ED consults P value n 994 474 217 Mean age 47.2±22.6 59.9±26 64.8±21.6 <0.001* Males (%) 685 (69) 259 (55) 121 (56) <0.001† Mechanism—fall (%) 265 (27) 283 (60) 134 (62) <0.001† Mechanism—MVC (%) 349 (35) 103 (22) 21 (10) <0.001* Mean door to physician evaluation (min) 0.5±3.0 8.7±16.7 9.9±17.9 <0.001* Mean door to CT scan (min) 25.4±11.2 50.0±59.9 95.4±71.0 0.0495 Mortality (%) 40 (4) 7 (2) 7 (3) 0.0348‡ Admitted to trauma service (%) 591 (60) 76 (16) 213 (98) <0.001† Mean LOS¶ (days) 7.6±9.9 4.7±2.9 4.8±5.8 <0.001† Median LOS¶ (IQR) 5 (3, 8) 4 (3, 5.25) 3 (2, 5) <0.001§ Χ2 and one-way analysis of variance (ANOVA) with Tukey tests used for comparison.
*Difference between all three groups (Tukey test).
†Difference between TA and TR and TA and non-TR consult (Tukey test).
‡Difference between TA and TR (Tukey test).
§Difference between TA and non-TR consult and TR and non-TR consult (Tukey test).
¶Calculation applies only to admitted patients.
ED, emergency department; LOS, length of stay; MVC, motor vehicle crash; TA, trauma activation; TR, trauma resource.
- Table 4
TR patient characteristics before and after pit stop implementation
TR before pit stop TR after pit stop P value n 318 474 Mean age 52.5±25.6 59.9±26 <0.001 Males (%) 189 (59) 259 (55) 0.191 Mortality (%) 3 (1) 7 (1.5) 0.543 Mean LOS* (days) 3.7±3.4 4.7±2.9 0.0423 Discharged from ED (%) 221 (70) 346 (73) 0.2846 Mean door to physician evaluation (min) 6.9±10.7 8.6±16.7 0.1084 Mean door to CT scan (min) 67.7±34.6 50.0±59.9 <0.001 Bold values indicate statistical signficance.
*Calculation applies only to admitted patients.
ED, emergency department; LOS, length of stay; TR, trauma resource.
