Utilization of crash scene photos of vehicle damage and intrusion to improve trauma care preparedness

摘要

Objective To design, develop, and field test a smartphone app (called TraumaHawk) that would transmit photographic vehicle crush information to a trauma center in advance of patient arrival, then determine whether such information increases the amount of lead time the trauma center has to activate and prepare for treating crash injured patients. Methods TraumaHawk, a smartphone app for law enforcement and first responders, was designed by the University of Iowa to send photographs showing extent of intrusion and vehicle damage in a vehicle's occupant compartment to the receiving trauma center. With some basic training, first-responders and law enforcement personnel were taught how to photograph vehicles at a crash scene; trauma staff similarly received training regarding crash injury biomechanics and traumatology. For TraumaHawk cases received October 2013-August 2014, electronic medical records and trauma team notification pages were examined. Time of notification and actual time of patient arrival were noted. Time of TraumaHawk alert for these cases was also recorded. Traditional paging and TraumaHawk lead-times (minutes) were calculated. A paired t-test was used to determine if the mean lead-times for the Paging and TraumaHawk alerts differed significantly. Results During the study period, 35 TraumaHawk cases were identified, and 32 met trauma team activation criteria. For these 32, actual mean time between the trauma team page and patient arrival was 12 min; for TraumaHawk, advance notice was received at the trauma center 26 minutes before patient arrival, more than doubling notification time (p<0.001). Conclusions Utiltizing TraumaHawk to identify serious crashes remotely allowed the trauma team significantly more time to prepare for incoming trauma patients than the conventional ambulance crew notification. This allotted time allowed trauma staff to assemble a more complete and appropriate level of care by specialists, as well as to arrange other vital aspects of care - such as scheduling operating rooms.