Literature DB >> 19159120

[Polytrauma management in a period of change: time analysis of new strategies for emergency room treatment].

T Wurmb1, H Balling, P Frühwald, T Keil, M Kredel, R Meffert, N Roewer, J Brederlau.   

Abstract

BACKGROUND: Quality management and the early implementation of whole-body multi-slice spiral computed tomography (whole-body MSCT) are becoming increasingly important in the management of patients with multiple trauma. The aim of this study was to evaluate both components with respect to the time factor for treatment.
METHODS: The investigation involved a retrospective data analysis of the time needed in the emergency room for the initial stabilization (phase A), completing the diagnosis (phase B) and the emergency room treatment (phase C). The investigation included three groups: trauma patients imaged in the emergency room with conventional imaging procedures (group I), with whole-body MSCT alone (group II) and those who were imaged with whole-body MSCT after the introduction of a quality management system with standard operating procedures (group III).
RESULTS: The times for resuscitation (phase A), for diagnostic evaluation (phase B) and for total treatment (phase C) were analyzed. The times for phase A were for group I (n=79) 10 min (interquartile range, IQR 8-12 min), group II (n=82) 13 min (IQR 10-17 min) and group III (n=79) 10 min (IQR 8-15 min; p<0.001). The times for phase B were 70 min (IQR 56-85 min) for group I, 23 min (IQR 17-33 min) for group II and 17 min (IQR 13-21 min; p<0.001) for group III. For phase C the times were 82 min (IQR 66-110 min) for group I, 47 min (IQR 37-59 min) for group II and 42 min (IQR 34-52 min; p<0.05) for group III.
CONCLUSION: Quality management and the early implementation of whole-body MSCT can accelerate the treatment work flow. A rapid initial diagnosis represents an important component in the high quality of treatment of polytrauma patients.

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Mesh:

Year:  2009        PMID: 19159120     DOI: 10.1007/s00113-008-1528-3

Source DB:  PubMed          Journal:  Unfallchirurg        ISSN: 0177-5537            Impact factor:   1.000


  33 in total

1.  [The Trauma Registry of the German Society of Trauma Surgery as a basis for interclinical quality management. A multicenter study of the German Society of Trauma Surgery].

Authors:  S Ruchholtz
Journal:  Unfallchirurg       Date:  2000-01       Impact factor: 1.000

2.  [Advanced Trauma Life Support (ATLS)].

Authors:  J A Sturm; Chr K Lackner; B Bouillon; A Seekamp; W E Mutschler
Journal:  Unfallchirurg       Date:  2002-11       Impact factor: 1.000

3.  [Diagnostic imaging in polytrauma: comparison of radiation exposure from whole-body MSCT and conventional radiography with organ-specific CT].

Authors:  U Wedegärtner; M Lorenzen; H D Nagel; C Weber; G Adam
Journal:  Rofo       Date:  2004-07

4.  Whole-body multislice computed tomography as the primary and sole diagnostic tool in patients with blunt trauma: searching for its appropriate indication.

Authors:  Thomas Erik Wurmb; Peter Frühwald; Wittiko Hopfner; Norbert Roewer; Jörg Brederlau
Journal:  Am J Emerg Med       Date:  2007-11       Impact factor: 2.469

5.  Introduction of a treatment algorithm can improve the early management of emergency patients in the resuscitation room.

Authors:  Michael Bernhard; Torben K Becker; Tim Nowe; Marko Mohorovicic; Marcus Sikinger; Thorsten Brenner; Goetz M Richter; Boris Radeleff; Peter-Jürgen Meeder; Markus W Büchler; Bernd W Böttiger; Eike Martin; André Gries
Journal:  Resuscitation       Date:  2007-02-06       Impact factor: 5.262

6.  [The Würzburg polytrauma algorithm. Concept and first results of a sliding-gantry-based computer tomography diagnostic system].

Authors:  T Wurmb; P Frühwald; J Brederlau; B Steinhübel; M Frommer; H Kuhnigk; M Kredel; J Knüpffer; W Hopfner; J Maroske; R Moll; R Wagner; A Thiede; G Schindler; N Roewer
Journal:  Anaesthesist       Date:  2005-08       Impact factor: 1.041

7.  Time to laparotomy for intra-abdominal bleeding from trauma does affect survival for delays up to 90 minutes.

Authors:  John R Clarke; Stanley Z Trooskin; Prashant J Doshi; Lloyd Greenwald; Charles J Mode
Journal:  J Trauma       Date:  2002-03

8.  [The role of whole body spiral CT in the primary work-up of polytrauma patients--comparison with conventional radiography and abdominal sonography].

Authors:  T Albrecht; J von Schlippenbach; P F Stahel; W Ertel; K-J Wolf
Journal:  Rofo       Date:  2004-08

9.  Causes and patterns of missed injuries in trauma.

Authors:  A Hirshberg; M J Wall; M K Allen; K L Mattox
Journal:  Am J Surg       Date:  1994-10       Impact factor: 2.565

Review 10.  [Trauma network of the German Association of Trauma Surgery (DGU). Establishment, organization, and quality assurance of a regional trauma network of the DGU].

Authors:  S Ruchholtz; C A Kühne; H Siebert
Journal:  Unfallchirurg       Date:  2007-04       Impact factor: 1.000

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  16 in total

1.  [Different case fatality rates at German trauma centres : Critical analysis].

Authors:  P Hilbert; R Lefering; R Stuttmann
Journal:  Anaesthesist       Date:  2010-06-09       Impact factor: 1.041

2.  [Quality circle in a trauma network of the German Association for Trauma Surgery. Upgrading patient care].

Authors:  A Ernstberger; M Koller; M Nerlich
Journal:  Unfallchirurg       Date:  2011-02       Impact factor: 1.000

3.  A case-matched series of immediate total-body CT scanning versus the standard radiological work-up in trauma patients.

Authors:  Joanne C Sierink; Teun Peter Saltzherr; Ludo F M Beenen; Marjolein J A M Russchen; Jan S K Luitse; Marcel G W Dijkgraaf; J Carel Goslings
Journal:  World J Surg       Date:  2014-04       Impact factor: 3.352

4.  [Trauma centre admission of severely injured or critically ill patients: comparison of estimated and real arrival times].

Authors:  T Wurmb; H Jansen; M Böttcher; M Kredel; C Wunder; A Gehrmann; N Roewer; R Muellenbach
Journal:  Unfallchirurg       Date:  2014-03       Impact factor: 1.000

5.  The treatment of patients with severe and multiple traumatic injuries.

Authors:  Edmund A M Neugebauer; Christian Waydhas; Sven Lendemans; Dieter Rixen; Michaela Eikermann; Tim Pohlemann
Journal:  Dtsch Arztebl Int       Date:  2012-02-10       Impact factor: 5.594

6.  [Optimized resource mobilization and quality of treatment of severely injured patients through a structured trauma room alarm system].

Authors:  C Spering; M Roessler; T Kurlemann; K Dresing; K M Stürmer; W Lehmann; S Sehmisch
Journal:  Unfallchirurg       Date:  2018-11       Impact factor: 1.000

7.  [Teamwork and leadership in the trauma room. Trauma room management from a psychological perspective].

Authors:  S Passauer-Baierl; G Hofinger
Journal:  Unfallchirurg       Date:  2011-09       Impact factor: 1.000

8.  [German trauma centers: level-dependent differences in polytrauma care regarding resources and diagnostic concepts].

Authors:  J Bayer; G Pache; T O Hammer; J Zwingmann; N P Südkamp; P C Strohm
Journal:  Chirurg       Date:  2013-04       Impact factor: 0.955

9.  Mobile, real-time, and point-of-care augmented reality is robust, accurate, and feasible: a prospective pilot study.

Authors:  Hannes Götz Kenngott; Anas Amin Preukschas; Martin Wagner; Felix Nickel; Michael Müller; Nadine Bellemann; Christian Stock; Markus Fangerau; Boris Radeleff; Hans-Ulrich Kauczor; Hans-Peter Meinzer; Lena Maier-Hein; Beat Peter Müller-Stich
Journal:  Surg Endosc       Date:  2018-03-30       Impact factor: 4.584

10.  Changes in trauma management following the implementation of the whole-body computed tomography: a retrospective multi-centre study based on the trauma registry of the German Trauma Society (TraumaRegister DGU®).

Authors:  H-G Palm; M Kulla; M Wettberg; R Lefering; B Friemert; P Lang
Journal:  Eur J Trauma Emerg Surg       Date:  2017-11-03       Impact factor: 3.693

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