The primary objective of this study was to determine the compliance rate with ATLS protocols in the ED in a Canadian Level I trauma centre, as well as to assess the impact on ATLS compliance with TTL involvement. Secondary Baf-A1 objectives included assessing patient outcomes and times to diagnostic imaging. Methods This study was conducted in a Level

I trauma center in Canada. check details Ethics approval for the study was obtained from the Human Research Ethics Review Board at the University of Alberta. Patients meeting inclusion criteria were identified from the Alberta Trauma Registry (ATR) from July 1, 2009 to June 30, 2010. Inclusion criteria were: age ≥17 years old, Injury Severity Score (ISS) ≥12, and patients with injuries www.selleckchem.com/products/sbe-b-cd.html that occurred <24 hours prior to presentation to the trauma centre. Patients with non-acute injuries (injuries sustained ≥24hrs), drowning, strangulations, missing charts and inter-hospital transfers that bypassed ED assessment were excluded. The ATR collects data prospectively on all trauma patients with an ISS ≥12 who are admitted to one of the ten participating trauma centers in Alberta. Data obtained from the ATR included: date of injury, sex, age, mechanism of injury, discharge status, total length of stay (LOS), ICU (Intensive Care Unit)

LOS, ISS, and revised trauma score (RTS). A retrospective chart review was performed for additional data not collected in the ATR, on the completion of various actions or tasks as per ATLS protocols (see Table 2), as well as time to diagnostic tests, readmission to hospital, and presence or absence of TTL during resuscitation. Readmission rate in medroxyprogesterone this study included all unplanned readmissions to a hospital in Alberta within 60 days of discharge. Criteria for trauma team and/or TTL activation Respiratory distress Hemodynamic instability Focal neurological signs or GCS ≤8 Penetrating torso trauma Multiple casualties Major burn At the discretion of the ED physician or charge

nurse At the time of the study, the core trauma team was composed of the TTL, senior and junior general surgery residents, orthopedic resident, anesthesia resident, along with nursing staff, radiology technicians, and respiratory therapists. Attending surgeons were available within 30 minutes while on-call. Other surgical specialties (neurosurgery, thoracics, vascular), intensivist, as well as hemoatologist were available upon request. The decision to activate the trauma team was based on criteria listed above. In cases where the trauma team was not activated, it was at the discretion of the ED physician in charge to consult the appropriate services. TTLs were multidisciplinary and composed of emergency physicians, general surgeons, and one neurosurgeon. All of the TTLs have ATLS certification, and a strong interest in trauma. Members of the TTL group are involved in ATLS education, quality assurance, and research.