Application des recommandations européennes pour la prise en charge des patients traumatisés: une étude observationnelle monocentrique

Translated title of the contribution: Compliance with the European trauma guidelines: An observational single centre study

Y. Rossignol, O. Huet, X. Chapalain, P. Le Maguet, R. Sparrow, E. L'Her, C. Le Niger, Y. Ozier, C. Aubron

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Abstract

Objectives: The European trauma guidelines were developed to assist clinicians in the early phase of trauma management to diagnose and treat coagulopathy and bleeding. This study aimed to determine compliance with these European trauma guidelines in a French referral trauma centre. Methods: Medical charts of trauma patients with an injury severity score ≥ 16 admitted between January 2013 and December 2014 were reviewed. Compliance with 21 recommendations in the first 24-hours of patient management was assessed. Results: There were 145 patients with median ISS of 34 [IQR 25–41]. A good level of compliance (i.e. applied in ≥ 80% of patients) was identified for nine recommendations, inconsistent compliance (i.e. applied in 50 to 79% of patients) for six recommendations, including fibrinogen levels at hospital admission and achievement of a target mean arterial blood pressure (MAP) > 80 mmHg in patients with major bleeding and TBI (55.5%), and poor compliance (i.e. applied in < 50% of patients) for another six recommendations. Poorly applied recommendations included early measurement of lactate or base deficit (32%), early administration of tranexamic acid (18%), and achievement of normocapnia in patients with TBI undergoing invasive ventilation (3%). Conclusions: In a referral trauma centre, nine of the 21 evaluable recommendations in the European trauma guidelines were applied in ≥ 80% of patients. Early diagnosis and treatment of trauma-related coagulopathy was identified as an area for significant practice improvement. In patients with TBI, efforts should be made to achieve the targeted MAP and to maintain normocapnia.

Translated title of the contributionCompliance with the European trauma guidelines: An observational single centre study
Original languageFrench
Pages (from-to)18-26
Number of pages9
JournalTransfusion Clinique et Biologique
Volume26
Issue number1
DOIs
Publication statusPublished - Feb 2019

Keywords

  • Bleeding
  • Coagulopathy
  • Guidelines
  • Injury
  • Trauma

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