Annals of Emergency Medicine
Volume 50, Issue 1 , Pages 7-12.e1 , July 2007

Trauma Management Outcomes Associated With Nonsurgeon Versus Surgeon Trauma Team Leaders

  • Jennifer M. Ahmed, MA

      Affiliations

    • Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
    • ,
  • John M. Tallon, MD, FRCPC

      Affiliations

    • Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
    • Nova Scotia Trauma Program, Halifax, Nova Scotia, Canada
    • Department of Emergency Medicine, Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia, Canada
    • Department of Surgery, Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia, Canada.
    • Corresponding Author InformationAddress for correspondence: John M. Tallon, MD, FRCPC, Nova Scotia Trauma Program, Rm 1-026B, 1st Floor Centennial Building, 1278 Tower Road, Halifax, NS, B3H 2Y9, Canada; 902-473-7157, fax 902-473-5835
    • ,
  • David A. Petrie, MD, FRCPC

      Affiliations

    • Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
    • Department of Emergency Medicine, Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia, Canada

Received 27 July 2006 ,Revised 2 September 2006 ,Accepted 20 September 2006.

References 

  1. Committee on Trauma, American College of Surgeons. Resources for Optimal Care of the Injured Patient: 1999. Chicago, IL: American College of Surgeons; 1998;
  2. Green SM. Is there evidence to support the need for routine surgeon presence on trauma patient arrival?. Ann Emerg Med. 2006;47:405–411
  3. The Trauma Association of Canada. Trauma System Accreditation Guidelines. Toronto, Canada: Trauma Association of Canada; 2003;
  4. EAST Practice Management Guidelines Work Group. Practice Management Guidelines for the Nonoperative Management of Blunt Injury to the Liver and Spleen. East Northport, NY: Eastern Association for the Surgery of Trauma; 2003;
  5. Engelhardt S, Hoyt D, Coimbra R, et al. The 15-year evolution of an urban trauma center: what does the future hold for the trauma surgeon?. J Trauma. 2001;51:633–638
  6. Fulda GJ, Tinkoff GH, Giberson F, et al. In-house trauma surgeons do not decrease mortality in a level I trauma center. J Trauma. 2002;53:494–502
  7. Green SM, Rothrock SG. Is pediatric trauma really a surgical disease?. Ann Emerg Med. 2002;39:537–540
  8. Helling TS, Nelson PW, Shook JW, et al. The presence of in-house attending trauma surgeons does not improve management or outcome of critically injured patients. J Trauma. 2003;55:20–25
  9. Offner PJ, Hawkes A, Madayag R, et al. General surgery residents improve efficiency but not outcome of trauma care. J Trauma. 2003;55:14–19
  10. Ciesla DJ, Moore EE, Moore JB, et al. Intubation alone does not mandate trauma surgeon presence on patient arrival to the emergency department. J Trauma. 2004;56:937–942
  11. Porter JM, Ursic C. Trauma attending in the resuscitation room: does it affect outcome?. Am Surg. 2001;67:611–614
  12. Moore EE. Role of the acute care surgeon in the emergency department management of trauma. Ann Emerg Med. 2006;47:413–414
  13. Khetarpal S, Steinbrunn BS, McGonigal MD, et al. Trauma faculty and trauma team activation: impact on trauma system function and patient outcome. J Trauma. 1999;47:576–581
  14. Nova Scotia Trauma Program. Trauma Registry Report on Injury in Nova Scotia: Provincial Report Data Year 2003-2004. Nova Scotia Trauma Program; 2006;
  15. Government of Nova Scotia. Emergency health services. Available at: http://www.gov.ns.ca/health/ehs. Accessed June 7, 2006.
  16. Tallon JM, Fell DB, Ackroyd-Stolarz S, et al. Influence of a new province-wide trauma system on motor vehicle trauma care and mortality. J Trauma. 2006;60:548–552
  17. Champion HR, Codes WS, Sacco WJ, et al. The Major Trauma Outcome Study: establishing norms for trauma care. J Trauma. 1990;30:1356–1365
  18. Canadian Institute for Health Information. National Trauma Registry Report: Major Injury in Canada, 2003-2004. 2006;
  19. Barringer ML. Experience at a level III trauma center. Available at: http://www.ptsf.org/060508.ppt. Accessed June 30, 2006.
  20. Petrie D, Lane P, Stewart TC. An evaluation of patient outcomes comparing trauma team activated versus trauma team not activated using TRISS analysis: Trauma and Injury Severity Score. J Trauma. 1996;41:870–873
  21. Nathens AB, Jurkovich GJ, Cummings P, et al. The effect of organized systems of trauma care on motor vehicle crash mortality. JAMA. 2000;283:1990–1994
  22. Cayten CG, Quervalu I, Agarwal N. Fatality analysis reporting system demonstrates association between trauma system initiatives and decreasing death rates. J Trauma. 1999;46:751–756
  23. Mullins RJ, Mann NC, Hedges JR, et al. Preferential benefit of implementation of a statewide trauma system in one of two adjacent states. J Trauma. 1998;44:609–617
  24. Nathens AB, Jurkovich GJ, Rivara FP, et al. Effectiveness of state trauma systems in reducing injury-related mortality: a national evaluation. J Trauma. 2000;48:25–31
  25. Klein KJ, Ziegert JC, Knight AP, et al. A leadership system for emergency action teams: rigid hierarchy and dynamic flexibility. 2006;Available at: http://knowledge.wharton.upenn.edu/papers/1282.pdf. Accessed June 7

 Supervising editor: Judd E. Hollander, MD

 Author contributions: JMT conceived the study. JMA and JMT designed the study and obtained research funding. JMA completed the request for data through the trauma registry, and JMT supervised the data collection. JMA, JMT, and DAP provided data analysis advice. JMA and JMT provided statistical advice. JMA performed the statistical analyses. All authors contributed to the drafting of the article and to its revision. All authors saw and approved the final article. JMA takes responsibility for the paper as a whole.

 Funding and support: JMA held a DMRF/Faculty of Medicine summer studentship with funding provided by a Dalhousie Medical Research Foundation Music-in-Medicine Studentship.

 Available online November 15, 2006.Reprints not available from the authors.

PII: S0196-0644(06)02272-4

doi: 10.1016/j.annemergmed.2006.09.017

Annals of Emergency Medicine
Volume 50, Issue 1 , Pages 7-12.e1 , July 2007

Article Tools