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Comparative Study
. 1990 Jun 16;300(6739):1560-3.
doi: 10.1136/bmj.300.6739.1560.

Improving the care of patients with major trauma in the accident and emergency department

R B Fisher  1 , C H Dearden
Affiliations
Comparative Study

Improving the care of patients with major trauma in the accident and emergency department

R B Fisher et al. BMJ. .

Abstract

Objective: To determine whether improvement in the care of victims of major trauma could be made by using the revised trauma score as a triage tool to help junior accident and emergency doctors rapidly identify seriously injured patients and thereby call a senior accident and emergency specialist to supervise their resuscitation.

Design: Comparison of results of audit of management of all seriously injured patients before and after these measures were introduced.

Setting: Accident and emergency department in an urban hospital.

Patients: All seriously injured patients (injury severity score greater than 15) admitted to the department six months before and one year after introduction of the measures.

Results: Management errors were reduced from 58% (21/36) to 30% (16/54) (p less than 0.01). Correct treatment rather than improvement in diagnosis or investigation accounted for almost all the improvement.

Conclusions: The management of seriously injured patients in the accident and emergency department can be improved by introducing two simple measures: using the revised trauma score as a triage tool to help junior doctors in the accident and emergency department rapidly identify seriously injured patients, and calling a senior accident and emergency specialist to supervise the resuscitation of all seriously injured patients.

Implications: Care of patients in accident and emergency departments can be improved considerably at no additional expense by introducing two simple measures.

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References

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    1. Br Med J (Clin Res Ed). 1988 May 7;296(6632):1305-8 - PubMed
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