title: Using a new evidence-based trauma protocol to improve detection and reduce costs in patients with blunt cardiac injury.
abstract: BACKGROUND
  Management of blunt cardiac injury is often discussed in trauma literature due to the lack of a "gold standard" for early identification and cost-effective care. The effectiveness of an evidence-based trauma protocol was assessed by comparing patients treated with the new protocol to those managed with prior practice.
  
  
  METHODS
  The data of 80 patients prospectively managed using the new trauma protocol were compared with the medical records of 80 former patients treated according to existing practice.
  
  
  RESULTS
  Implementing the new protocol improved detection of abnormal troponin I levels and resulted in cost savings. The length of time inpatients required continuous electrocardiographic monitoring decreased by 4.23 days and echocardiography use dropped by 70%.
  
  
  CONCLUSIONS
  Implementation of the evidence-based trauma protocol at our facility improved the early identification of patients with blunt cardiac injury and reduced the number of laboratory and diagnostic tests.
authors.affiliation: Surgical Intermediate Care Center (SICC), (Ms Genrich), Cardiac Surgery (Ms O'Mara), and Patient Centered Outcomes Research, James R. & Helen D. Russell Institute for Research & Innovation, (Dr Sulo), Advocate Lutheran General Hospital, Park Ridge, Illinois.
authors.forename: Ilean
authors.initials: I
authors.lastname: Genrich
authors.forename: Susan K
authors.initials: SK
authors.lastname: OʼMara
authors.forename: Suela
authors.initials: S
authors.lastname: Sulo
mesh_terms: D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D017046:Cost Savings; D004562:Electrocardiography / Q000379:methods; D055317:Evidence-Based Practice / Q000191:economics*; D005260:Female; D006335:Heart Injuries / Q000175:diagnosis* / Q000191:economics / Q000628:therapy; D017721:Hospital Costs; D006801:Humans; D015601:Injury Severity Score; D007902:Length of Stay / Q000191:economics*; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000191:economics; D011379:Prognosis; D011446:Prospective Studies; D012189:Retrospective Studies; D018570:Risk Assessment; D014193:Trauma Centers / Q000458:organization & administration; D019210:Troponin I / Q000097:blood; D014949:Wounds, Nonpenetrating / Q000175:diagnosis* / Q000191:economics / Q000628:therapy
chemical_list: D019210:Troponin I