改善损伤控制手术过程中的沟通:英国成人重大创伤中心调查。

IF 1.1 4区 医学 Q3 SURGERY
E N Patton, I Lisagors, I Tyrrell-Marsh, S Agarwal, L V Wee, A Darwish, S R Smith
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引用次数: 0

摘要

导言:非技术性技能方面的缺陷会严重阻碍团队在高强度情况下的运作,例如为重伤的创伤患者进行损伤控制手术。根据世界卫生组织标准术前检查表修改而成的截断式术前检查表,以及在手术过程中每隔一段时间进行的情况报告,是军队中长期沿用的做法,也是国家卫生局重大事件指南中的推荐做法。这些工具可以让多专业团队建立麻醉和手术计划的共享心理模型,从而提高团队效率。我们的目的是确定英格兰的成人重大创伤中心是否在损害控制手术中使用了截短的术前核对表和情况报告:方法:我们设计了一项在线调查,并于 2020 年 11 月通过国家创伤护理计划进行分发:结果:英格兰所有 23 个成人重大创伤中心均做出了回复。9个中心(39.1%)报告使用了截短的损伤控制手术术前检查表,尽管格式各不相同。常见的内容包括已收到和/或可用的血液制品、是否存在过敏、氨甲环酸和抗生素的使用、粘弹性测试的可用性、所需设备、细胞保存器的可用性、角色分配和所需其他人员的参考以及计划的讨论。有 12 个中心(52.2%)制定了正式的情况报告政策。同样,这些政策有多种形式,但都侧重于病人的生理状况,以指导手术规划:我们已经确定了损伤控制手术中先进通信辅助工具的关键组成部分,为其他主要创伤中心建立自己的潜在救生工具提供了基础。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Improving communication during damage control surgery: a survey of adult major trauma centres in England.

Introduction: Deficiencies in non-technical skills can severely impede the functioning of teams in high-intensity scenarios, such as in damage control surgery for the critically injured trauma patient. Truncated preoperative checklists, modified from the standard World Health Organization preoperative checklist, and situational reporting at intervals during surgery are long-established practices in the military, and are recommended in the National Health Service guidelines on major incidents. These tools allow the multiprofessional team to create a shared mental model of the anaesthetic and operative plan, thereby improving team efficiency. Our aim was to establish whether adult major trauma centres in England are using truncated preoperative checklists and situational reporting for damage control surgery.

Methods: An online survey was devised and distributed via the national programme of care for trauma in November 2020.

Results: Responses were received from all 23 adult major trauma centres in England. Nine centres (39.1%) reported using a truncated preoperative checklist for damage control surgery albeit in a variety of formats. Common components were blood products received and/or available, presence of allergies, tranexamic acid and antibiotic administration, availability of viscoelastic tests, equipment required, availability of cell saver, role allocation and reference to other personnel needed, and discussion of the plan. Twelve centres (52.2%) have formal policies in place for situational reporting. Again, these were in multiple formats but all focused on patient physiology to direct surgical planning.

Conclusions: We have identified key components to advanced communication aids for damage control surgery, providing a foundation on which other major trauma centres can build their own versions of these potentially lifesaving tools.

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来源期刊
CiteScore
2.40
自引率
0.00%
发文量
316
期刊介绍: The Annals of The Royal College of Surgeons of England is the official scholarly research journal of the Royal College of Surgeons and is published eight times a year in January, February, March, April, May, July, September and November. The main aim of the journal is to publish high-quality, peer-reviewed papers that relate to all branches of surgery. The Annals also includes letters and comments, a regular technical section, controversial topics, CORESS feedback and book reviews. The editorial board is composed of experts from all the surgical specialties.
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