An assessment of time following trauma resuscitation: the transitional evaluation and monitoring phase.
Trauma resuscitation for 431 major trauma patients averaged 24 +/- 0.61 minutes. Further analysis of the care of 350 of these patients documented a transitional evaluation and monitoring phase (TEMP), with a physician and nurse in attendance, for an additional 158 +/- 12 minutes until arrival at the operating room, surgical intensive care unit (SICU), hospital ward, or discharge. The duration of TEMP did not vary according to severity of injury (R2 = 0.02). Arrival time (days: 167 +/- 23 minutes; evenings: 142 +/- 13 minutes; and nights: 147 +/- 30 minutes) had minimal effect on TEMP duration. The TEMP for 67 patients undergoing an operation was significantly less than for patients admitted to the hospital ward or SICU (112 +/- 19 minutes vs. 171 +/- 20, p less than 0.05). These 350 patients underwent 582 activities during TEMP including radiologic evaluation (265), CT scan (173), and other activities (144). Extrapolating TEMP time for the 1,800 major trauma patients seen annually, this represents 4,740 hours each of nursing and physician time. A better understanding of TEMP is needed to provide appropriate support and organization during this critical period of trauma care.
Department of Surgery, Yale University School of Medicine, New Haven, CT 06510.
D K
DK
Lowe
J R
JR
Hedges
D W
DW
Marby
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D
Mendelson
D004630:Emergencies; D006801:Humans; D015601:Injury Severity Score; D007362:Intensive Care Units; D008499:Medical Records; D011446:Prospective Studies; D012151:Resuscitation; D013997:Time Factors; D014193:Trauma Centers; D014947:Wounds and Injuries / Q000175:diagnosis / Q000628:therapy*