Communication during trauma resuscitation: do we know what is happening?
OBJECTIVE
Verbal communication is essential for teamwork and leadership in high-intensity performances like trauma resuscitation. We evaluated communication during multidisciplinary trauma resuscitation.


METHODS
The main trauma room of a level one trauma centre was equipped with a digital video recording system. Resuscitations were consecutively and prospectively enrolled. Patients with revised trauma score (RTS)=12 were resuscitated by a 'minor trauma team' and patients with RTS<12 by a 'major trauma team'. Information transferral from physicians to other team members was evaluated separately for all ABCDE's, according to initiation, audibility and response. The observer was trained and the first 30 video's were excluded.


RESULTS
From May 1st to September 1st 2003, 205 resuscitations were included, 12 were lost for evaluation. The 'major trauma team' resuscitated 74 patients (ISS:21.4). Communication was audible in 56% and understandable in 44% during the primary survey. The 'minor trauma team' assessed 119 patients (ISS:7.4). Communication was audible in 43% and understandable in 33%.


CONCLUSIONS
Communication during trauma resuscitation was found to be sub optimal. This is potentially harmful for trauma victims. Professionals and institutions should be aware that communication is not self-evident. Introduction of an aviation-like communication feedback system could help to optimise trauma care.
Department of Surgery, Traumacenter of the South-West Netherlands, ErasmusMC, University Hospital Rotterdam, Rotterdam, Netherlands. eagbergs@hotmail.com
Engelbert A G
EA
Bergs
Frans L P A
FL
Rutten
Tamer
T
Tadros
Pieta
P
Krijnen
Inger B
IB
Schipper
D000328:Adult; D003142:Communication; D005260:Female; D006801:Humans; D007400:Interprofessional Relations; D008297:Male; D010348:Patient Care Team / Q000592:standards*; D012151:Resuscitation; D014193:Trauma Centers / Q000458:organization & administration*; D014194:Traumatology / Q000458:organization & administration; D014947:Wounds and Injuries / Q000628:therapy*