Application of standard operating procedures accelerates the process of trauma care in patients with multiple injuries.
OBJECTIVE
Objective of this study is to determine whether the formulation of standard operating procedures (SOPs) and their incorporation in a trauma pathway are associated with an improvement of trauma treatment process.


METHODS
A retrospective data analysis of traumatized patients treated before the introduction of the SOPs (group I) and after a SOP training period of 6 months (group II) was performed. The time required for resuscitation (period A), diagnostic workup (period B) and total stay in the emergency room (period C) was used as a marker of trauma team performance. Data are described as median and interquartile range. Mortality within the first 24 h and within 30 days was determined.


RESULTS
Eighty-two patients in group I and 79 patients in group II were analysed. Period A took 13 (10-17) min in group I and 10 (8-15) min in group II, respectively (P<0.001). Period B was finished after 23 (17-33) min in group I and after 17 (13-21) min in group II (P<0.001). Period C took 47 (37-59) min in group I and 42 (34-53) min in group II, respectively (P<0.05). A difference in mortality was not observed.


CONCLUSIONS
SOP incorporation in a trauma pathway shortens the total stay in the emergency room, resuscitation time and the time to achieve definitive diagnosis in multiple trauma patients. Thus, it can be concluded that organization and timing of trauma treatment steps help in improving the quality of trauma treatment process.
Wurmb
Thomas Erik
TE
Department of Anaesthesiology, University Hospital of Wuerzburg, Wuerzburg, Germany. wurmb_t@klinik.uni-wuerzburg.de
Frühwald
Peter
P
Knuepffer
Joachim
J
Schuster
Frank
F
Kredel
Markus
M
Roewer
Norbert
N
Brederlau
Jörg
J
D000293:Adolescent; D000328:Adult; D022561:Advanced Cardiac Life Support / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D002985:Clinical Protocols / Q000592:standards*; D005060:Europe; D005260:Female; D006801:Humans; D007223:Infant; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000601:surgery / Q000628:therapy*; D017064:Process Assessment, Health Care; D012189:Retrospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D014193:Trauma Centers / Q000592:standards* / Q000706:statistics & numerical data*; D055815:Young Adult