Streamlined trauma response team training improves imaging efficiency for pediatric blunt abdominal trauma

Infographic · Sep 2019 · 1 min read

In brief

Streamlined trauma team training at a pediatric center reduced CT acquisition time from 37 to 28 minutes and FAST scan time from 18 to 8 minutes, while increasing FAST utilization from 64% to 81%. The protocol changes also decreased time to operating room, potentially improving outcomes for bluntly injured children through faster injury identification and disposition.

Streamlined trauma team training reduced CT acquisition time by 24% (37 to 28 minutes) in pediatric blunt trauma patients
FAST scan utilization increased from 63.5% to 80.8% and time to FAST decreased by 56% (18 to 8 minutes) post-implementation
Faster imaging protocols correlated with reduced time to operating room, potentially improving outcomes in bluntly injured children
Formal trauma response protocols improve emergency department disposition efficiency through rapid injury identification
Standardized team approach demonstrates measurable impact on critical time metrics in pediatric trauma care

Written by the GCMD Library team from the infographic.

A two-column infographic with a dark blue left panel and teal right panel. The left side shows a training icon and participant icons with 'PRE-INTERVENTION' and 'POST-INTERVENTION' labels. The right side displays five columns of metrics with icons representing ultrasound, CT scanner, and stopwatches, showing percentage improvements and time reductions with arrows indicating directional changes.

The morbidity and mortality of children with traumatic injuries are directly related to the time to definitive management of their injuries. Imaging studies are used in the trauma evaluation to determine the injury type and severity. The goal of this project is to determine if a formal streamlined trauma response improves efficiency in pediatric blunt trauma by evaluating time to acquisition of imaging studies and definitive management.

Methods

This study is a chart review of patients <18 years who presented to a pediatric trauma center following blunt trauma requiring trauma team activation. 413 records were reviewed to determine if training changed the efficiency of CT acquisition and 652 were evaluated for FAST efficiency. The metrics used for comparison were time from ED arrival to CT image, FAST, and disposition.

Results

Time from arrival to CT acquisition decreased from 37 (SD 23) to 28 (SD27) min (p < 0.05) after implementation. The proportion of FAST scans increased from 315 (63.5%) to 337 (80.8%) and the time to FAST decreased from 18 (SD15) to 8 (SD10) min (p < 0.05). The time to operating room (OR) decreased after implementation.

Conclusion

The implementation of a streamlined trauma team approach is associated with both decreased time to CT, FAST, OR, and an increased proportion of FAST scans in the pediatric trauma evaluation. This could result in the rapid identification of injuries, faster disposition from the ED, and potentially improve outcomes in bluntly injured children.

Type of study

Therapeutic

Level of evidence

Level III

Visual abstract created by Alejandra M Casar Berazaluce, MD - Pediatric Surgery Research Fellow at Cincinnati Children's Hospital Medical Center.

The text in the image

Streamlined Trauma Response Team Training Improves Imaging Efficiency | Blunt Abdominal Trauma <18yr | Norton Children's Hospital | University of Louisville | Trauma Team Training | Simulation-based | Est. 2014 | PRE-INTERVENTION | POST-INTERVENTION | FAST/E-FAST | CT Scan* (w/FAST) | Time to FAST | Time to CT Scan | Time to Disposition | 66% | 43% | 18 m | 37 m | Ward 03:04 PICU 02:06 OR 01:59 | p<0.05 | p<0.05 | p<0.05 | p>0.35 | 87% | 21% | 8 m | 28 m | Ward 03:12 PICU 01:59 OR 01:29 | Journal of Pediatric Surgery | Nti et al. Journal of Pediatric Surgery (2019) | https://doi.org/10.1016/j.jpedsurg.2018.12.013 | @alejandracasar

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