A time-management study of 25 patients with penetrating wounds of the chest and abdomen.
The present study prospectively reviewed the time management aspects of 25 patients with penetrating wounds of the chest or abdomen. Each diagnostic procedure or treatment carried out on each patient was recorded to the nearest minute after his arrival in the emergency department. This generated median elapsed times for procedures which could be compared (4+ minutes for starting an IV, 9 minutes for insertion of CVP, 31 minutes for insertion of a chest tube). Two of the 25 patients died; 20 were admitted of whom 8 required immediate surgery. Some preocedures carried out in the accident room were done indiscriminately and for questionable reasons. The tendency was to do as much as possible to "cover" the patient. Some redundancy in the acutely ill patient is desirable but the overtreatment in some cases may have reflected inexperience of some of the physicians. Delay in using radiography and defects in professional coverage appeared to be the most serious errors. Independent monitoring of the functioning of the accident room appears to be an affective means of self-evaluation.
D000007:Abdominal Injuries / Q000601:surgery*; D001803:Blood Transfusion; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000592:standards; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D007440:Intubation; D008297:Male; D010348:Patient Care Team; D013898:Thoracic Injuries / Q000601:surgery*; D013997:Time Factors; D014948:Wounds, Gunshot / Q000601:surgery; D014950:Wounds, Penetrating / Q000601:surgery*; D014951:Wounds, Stab / Q000601:surgery