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Nivåindelat traumaomhändertagande på NUS: En retrospektiv journalgranskning
Umeå University, Faculty of Medicine, Department of Nursing.
Umeå University, Faculty of Medicine, Department of Nursing.
2015 (Swedish)Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesisAlternative title
Two tiered traumacare at NUS : A retrospective records audit (English)
Abstract [en]

Aims: To describe the presence of trauma team activation and outcomes of health care interventions in two trauma team levels. Background: Trauma is the most common cause of death among Swedish men aged <44 years. Every year ca 4500 people in Sweden dies due to trauma. During the 90’s, hospitals in USA developed a two level trauma activation algorithm to speed up the initial assessment for the injured patients who needed it, and to conserve resources when patients didn’t need to see the full trauma team.

Design: This study is a retrospective records audit over trauma team activations during 2 years. Methods: This study audited trauma team activations through medical records during the period 1/1 2013 - 31/12 2014 on Norrlands university hospital in Umeå, Sweden. Results: Of all the trauma team activations 35% activated the large trauma team and 65% the small trauma team. Average age was 44 years and 61% of the patients were men while 39% were women. 36,3% of the large trauma team activations were in need of anaesthesiological interventions and 1% of the small trauma team activations. 47,8% was in need of Intensive care of the large trauma team activation and 3,5% of the small trauma team activation. 41,6% of the large trauma team activation was planned for surgery within the first 24-hours and 4,5 of the small. Mean wardtime was 8,49 days for the large trauma team activation and 2,86 days for small trauma team activation. Mortality for large trauma team activation was 8,8% compared to 1,5 of the small.

Conclusion: This study shows that two levels of trauma team activation can provide a safe and appropriate care. More longitudinal and multicenter studies is necessary for increased evidence.

Abstract [sv]

Syfte: Att beskriva förekomst av aktiverade traumalarm samt utfall av vårdinsatser i två traumalarmsnivåer. Bakgrund: Trauma är den vanligaste dödsorsaken bland män under 44år i Sverige, totalt avlider ca 4500 personer per år till följd av trauma. I USA infördes under 90-talet två traumalarmsnivåer för att öka patientsäkerheten och spara vårdresurser.

Design: Denna studie är en retrospektiv journalgranskning över traumalarm som inträffat under en 2 års period. Metod: Studien granskade aktiverade traumalarm via journaldata från perioden 1/1-2013 t.o.m 31/12-2014 på Norrlands Universitetssjukhus i Umeå.

Resultat: Av de aktiverade traumalarmen var 35% stora och 65% små. Medelåldern var 44år och 61% av patienterna var män medan 39% var kvinnor. 36,3% av de stora traumalarmen var i behov av narkoskompetens och 1% av de små. 47,8% av de stora traumalarmen var i behov av IVA-vård samt 3,5% av de små. 41,6% av stora traumalarm planerades för operation inom 24timmar och 4,5% av de små. Medelvårdtiden var 8,49 dygn för stora traumalarm och 2,86 dygn för små traumalarm. Mortaliteten för stort traumalarm var 8,8% jämfört med 1,5% av de små traumalarmen. Slutsats: Denna studie visar på att triagering enligt två traumalarmsnivåer för vuxna kan i hög grad ge en patientsäker och ändamålsenlig vård. Fler longitudinella och multicenterstudier i området är nödvändigt för ökad evidens 

Place, publisher, year, edition, pages
2015. , 21 p.
Keyword [sv]
trauma, nus, traumalarm, traumateam, akutmottagning, anestesi, triage
National Category
Nursing
Identifiers
URN: urn:nbn:se:umu:diva-118722OAI: oai:DiVA.org:umu-118722DiVA: diva2:915743
Educational program
Graduate Programme in Anesthetic Nursing
Supervisors
Available from: 2016-04-19 Created: 2016-03-30 Last updated: 2016-04-19Bibliographically approved

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CiteExportLink to record
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Citation style
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