Using trauma video review to search for the Goldilocks pre-activation time
Objectives We sought to determine the optimal time to pre-activation for trauma team activation that resulted in maximum team efficiency, measured by the time to complete critical actions (TCCAs) during resuscitation. We hypothesized that there exists a time window for trauma team pre-activation tha...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2024-12-01
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| Series: | Trauma Surgery & Acute Care Open |
| Online Access: | https://tsaco.bmj.com/content/9/1/e001588.full |
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| author | Eric Klein Ella Rose Rastegar Sophia Görgens Manuel Beltran del Rio Elizabeth Nilsson Sjolander Joseph Landers Cristy Meyer Daniel Rolston Maria Sfakianos Matthew Bank Daniel Jafari |
| author_facet | Eric Klein Ella Rose Rastegar Sophia Görgens Manuel Beltran del Rio Elizabeth Nilsson Sjolander Joseph Landers Cristy Meyer Daniel Rolston Maria Sfakianos Matthew Bank Daniel Jafari |
| author_sort | Eric Klein |
| collection | DOAJ |
| description | Objectives We sought to determine the optimal time to pre-activation for trauma team activation that resulted in maximum team efficiency, measured by the time to complete critical actions (TCCAs) during resuscitation. We hypothesized that there exists a time window for trauma team pre-activation that minimizes TCCA.Methods This is an exploratory retrospective analysis of video-reviewed traumas at a level 1 trauma center from January 1, 2018 to 28 February, 2022 that received the highest trauma team activation and had a pre-arrival notification. A total of 11 TCCA categories were calculated using video timestamps. To compare TCCAs from different categories, normalized TCCAs (nTCCAs) were calculated by dividing each TCCA by the median time of its category. Pre-activation times were categorized into three groups: long pre-activation (≥8 min), mid pre-activation (≥4 and ≤7 min), and short pre-activation (≥0 and ≤4).Results There were 466 video-recorded level 1 trauma activations, which resulted in 2334 TCCAs. Of the 466 activations, 152 occured on the patient’s arrival (0 min pre-activation). The majority (425) of patients had a pre-activation time of <7 min. Pre-activation of 4–6 min resulted in all but blood transfusion TCCAs being <15 min. Furthermore, mid pre-activation category corresponded to the most efficient trauma teams, with nTCCAs significantly shorter (median=0.75 (IQR 0.3–1.3)) than long (median=1 (IQR 0.6–2)) or short activation groups (median=1 (IQR 0.6–1.6)). A greater proportion of nTCCAs were shorter than their category median in the mid pre-activation category compared with long and short categories (59.1% vs 48.3% and 40%, respectively; p<0.01).Conclusions In this exploratory study, a pre-activation time of 4–7 min is associated with the best team efficiency as measured by TCCAs during trauma team activations. This timeframe may be an optimal window for trauma team activations but needs prospective and external validation.Level of evidence Level 4 retrospective exploratory study |
| format | Article |
| id | doaj-art-5f68978f72544df18a1007b2f24e0e60 |
| institution | OA Journals |
| issn | 2397-5776 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | Trauma Surgery & Acute Care Open |
| spelling | doaj-art-5f68978f72544df18a1007b2f24e0e602025-08-20T02:36:53ZengBMJ Publishing GroupTrauma Surgery & Acute Care Open2397-57762024-12-019110.1136/tsaco-2024-001588Using trauma video review to search for the Goldilocks pre-activation timeEric Klein0Ella Rose Rastegar1Sophia Görgens2Manuel Beltran del Rio3Elizabeth Nilsson Sjolander4Joseph Landers5Cristy Meyer6Daniel Rolston7Maria Sfakianos8Matthew Bank9Daniel Jafari101 Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USADepartment of Surgery at Zucker School of Medicine, Northwell Health, New Hyde Park, New York, USAEmergency Department, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USADepartment of Surgery at Zucker School of Medicine, Northwell Health, New Hyde Park, New York, USADepartment of Surgery at Zucker School of Medicine, Northwell Health, New Hyde Park, New York, USAZucker School of Medicine at Hofstra/Northwell, Northwell Health, New Hyde Park, New York, USADepartment of Surgery at Zucker School of Medicine, Northwell Health, New Hyde Park, New York, USADepartment of Emergency Medicine at Zucker School of Medicine, Northwell Health, New Hyde Park, New York, USADepartment of Surgery at Zucker School of Medicine, Northwell Health, New Hyde Park, New York, USADepartment of Surgery, South Shore University Hospital, Northwell Health, Bay Shore, New York, USADepartment of Emergency Medicine at Zucker School of Medicine, Northwell Health, New Hyde Park, New York, USAObjectives We sought to determine the optimal time to pre-activation for trauma team activation that resulted in maximum team efficiency, measured by the time to complete critical actions (TCCAs) during resuscitation. We hypothesized that there exists a time window for trauma team pre-activation that minimizes TCCA.Methods This is an exploratory retrospective analysis of video-reviewed traumas at a level 1 trauma center from January 1, 2018 to 28 February, 2022 that received the highest trauma team activation and had a pre-arrival notification. A total of 11 TCCA categories were calculated using video timestamps. To compare TCCAs from different categories, normalized TCCAs (nTCCAs) were calculated by dividing each TCCA by the median time of its category. Pre-activation times were categorized into three groups: long pre-activation (≥8 min), mid pre-activation (≥4 and ≤7 min), and short pre-activation (≥0 and ≤4).Results There were 466 video-recorded level 1 trauma activations, which resulted in 2334 TCCAs. Of the 466 activations, 152 occured on the patient’s arrival (0 min pre-activation). The majority (425) of patients had a pre-activation time of <7 min. Pre-activation of 4–6 min resulted in all but blood transfusion TCCAs being <15 min. Furthermore, mid pre-activation category corresponded to the most efficient trauma teams, with nTCCAs significantly shorter (median=0.75 (IQR 0.3–1.3)) than long (median=1 (IQR 0.6–2)) or short activation groups (median=1 (IQR 0.6–1.6)). A greater proportion of nTCCAs were shorter than their category median in the mid pre-activation category compared with long and short categories (59.1% vs 48.3% and 40%, respectively; p<0.01).Conclusions In this exploratory study, a pre-activation time of 4–7 min is associated with the best team efficiency as measured by TCCAs during trauma team activations. This timeframe may be an optimal window for trauma team activations but needs prospective and external validation.Level of evidence Level 4 retrospective exploratory studyhttps://tsaco.bmj.com/content/9/1/e001588.full |
| spellingShingle | Eric Klein Ella Rose Rastegar Sophia Görgens Manuel Beltran del Rio Elizabeth Nilsson Sjolander Joseph Landers Cristy Meyer Daniel Rolston Maria Sfakianos Matthew Bank Daniel Jafari Using trauma video review to search for the Goldilocks pre-activation time Trauma Surgery & Acute Care Open |
| title | Using trauma video review to search for the Goldilocks pre-activation time |
| title_full | Using trauma video review to search for the Goldilocks pre-activation time |
| title_fullStr | Using trauma video review to search for the Goldilocks pre-activation time |
| title_full_unstemmed | Using trauma video review to search for the Goldilocks pre-activation time |
| title_short | Using trauma video review to search for the Goldilocks pre-activation time |
| title_sort | using trauma video review to search for the goldilocks pre activation time |
| url | https://tsaco.bmj.com/content/9/1/e001588.full |
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