Supporting information use and retention of pre-hospital information during trauma resuscitation: a qualitative study of pre-hospital communications and information needs

Abstract

Pre-hospital communication is a critical first step towards ensuring efficient management of critically injured patients during trauma resuscitation. Information about incoming patients received from the field and en route serves a critical role in helping emergency medical teams prepare for patient care. Despite many efforts, inefficiencies persist. In this paper, we examine the pre-hospital communications between pre-hospital and hospital providers, including the types of information transferred during en-route calls, as well as the information needs of trauma teams. Our findings show that Emergency Medical Services (EMS) teams report a great deal of information from the field, most of which match the needs of trauma teams. We discuss design implications for a computerized system to support the use and retention of pre-hospital information during trauma resuscitation.

Figure 1:

Current ways of presenting pre-hospital information to trauma teams in US Level 1 trauma centers.

Figure 2:

Information types identified in EMS-ECIC communications, grouped into six high-level categories. Dark bars indicate the number of communications in which the information was reported by EMS teams. Gray bars indicate the number of communications in which the information was requested by ECIC teams.

Figure 3:

A sample of communications (events) showing their structure. T = Transportation, D = Demographics, M = Mechanism of injury, I = Injuries, TG = Treatments given, P = Physical findings.

Figure 4:

Macro-level vs. micro-level structure of pre-hospital communications. Top rows show the macro-level structure for two events. Bottom rows show the micro-level structure for the same two events.

Figure 5:

Pre-hospital information needs, ranked by the number of participants who expressed the need for a particular information type.