@article{ref1,
title="Accurate completion of tertiary trauma survey for inpatients at a non-trauma centre following significant trauma",
journal="Injury",
year="2022",
author="Ghamri, N. and Brand, M. K. R. and Henshall, K. and MacCormick, A. D.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="INTRODUCTION: A tertiary trauma survey (TTS) is a structured, comprehensive top-to-toe examination following major trauma [1]. Literature suggests that the ideal time frame for the initial TTS should be completed within 24-hours of a patient's admission and repeated at important moments [2-4]. Evidence suggests that formal TTS reduces the rate of missed injuries by up to 38% [2]. AIMS: To determine the rate of TTS being conducted in trauma patients in a tertiary hospital without an admitting trauma service. <br><br>METHODS: We performed a retrospective analysis of adult trauma patients admitted to Middlemore Hospital (MMH) over six months. To be included, patients were either deemed to have a significant mechanism of injury or triggered a trauma call when arriving in the Emergency Department. <br><br>RESULTS: We identified 246 patients who met our criteria for requiring a TTS. 74 (30%) had a TTS completed. Of those completed, 22 (30%) were documented using a standardised form. 35 (47%) were done within the ideal timeframe (24 h); a further 21 (28%) were done within 48 h. House Officers (Junior Medical Officers) conducted the majority (80%), with the remainder being done by final-year medical students (12%), Registrars (Residents) (4%) and Consultants (Attendings) (4%). Of the 74 TTS that were completed, 21 (28%) detected a possible new injury, with 22% leading to further investigations being ordered. 14 (19%) were found to have a previously undetected, clinically significant injury on TTS (defined as 'injuries requiring further clinical intervention'). Most patients (90%) were admitted to either General Surgery or Orthopaedics. Sixty-two (54%) of patients admitted to General Surgery received a TTS; compared to just 11 (10%) admitted under Orthopaedics and 1 of 24 (4%) admitted to other specialities (including Hands, Plastics, Maxillo-Facial, Gynaecology and Medicine). <br><br>CONCLUSION: 30% of patients requiring a TTS received one. 19% of TTS conducted detected clinically significant injuries.<p /> <p>Language: en</p>",
language="en",
issn="0020-1383",
doi="10.1016/j.injury.2022.07.052",
url="http://dx.doi.org/10.1016/j.injury.2022.07.052"
}