Protocol for a prospective observational study to improve prehospital notification of injured patients presenting to trauma centres in India

Biswadev Mitra, Joseph Mathew, Amit Gupta, Peter Cameron, Gerard O'Reilly, Kapil Dev Soni, Gaurav Kaushik, Teresa Howard, Madonna Fahey, Michael Stephenson, Vineet Kumar, Sharad Vyas, Satish Dharap, Pankaj Patel, Advait Thakor, Naveen Sharma, Tony Walker, Mahesh Chandra Misra, Russell Gruen, Mark Fitzgerald

Research output: Contribution to journalArticleOtherpeer-review

3 Citations (Scopus)

Abstract

Introduction Prehospital notification of injured patients enables prompt and timely care in hospital through adequate preparation of trauma teams, space, equipment and consumables necessary for resuscitation, and may improve outcomes. In India, anecdotal reports suggest that prehospital notification, in those few places where it occurs, is unstructured and not linked to a well-defined hospital response. The aim of this manuscript is to describe, in detail, a study protocol for the evaluation of a formalised approach to prehospital notification. Methods and analysis This is a longitudinal prospective cohort study of injured patients being transported by ambulance to major trauma centres in India. In the preintervention phase, prospective data on patients will be collected on prehospital assessment, notification, inhospital assessment, management and outcomes and recorded in a new tailored multihospital trauma registry. All injured patients arriving by ambulance and allocated to a red or yellow priority category will be eligible for inclusion. The intervention will be a prehospital notification application to be used by ambulance clinicians to notify emergency departments of the impending arrival of a patient. The proportion of eligible patients arriving to hospital after notification will be the primary outcome measure. Secondary outcomes evaluated will be availability of a trauma cubicle, presence of a trauma team on patient arrival, time to first chest X-ray and inhospital mortality. Progress Ethical approval has been obtained from the All India Institute of Medical Sciences, New Delhi and site-specific approval granted by relevant trauma services. The trial has also been registered with the Monash University Human Research and Ethics Committee; Project number: CF16/1814-2016000929. Results will be fed back to prehospital and hospital clinicians via a series of reports and presentations. These will be used to facilitate discussions about service redesign and implementation. It is expected that evidence for improved outcomes will enable widespread adoption of this intervention among centres in all settings with less established tools for prehospital assessment and notification. Trial registration number NCT02877342; Pre-results.

Original languageEnglish
Article numbere014073
JournalBMJ Open
Volume7
Issue number7
DOIs
Publication statusPublished - 1 Jul 2017

Keywords

  • Accident & Emergency Medicine
  • Ambulance
  • Notification
  • Trauma Management
  • Wounds and Injuries

Cite this

Mitra, Biswadev ; Mathew, Joseph ; Gupta, Amit ; Cameron, Peter ; O'Reilly, Gerard ; Soni, Kapil Dev ; Kaushik, Gaurav ; Howard, Teresa ; Fahey, Madonna ; Stephenson, Michael ; Kumar, Vineet ; Vyas, Sharad ; Dharap, Satish ; Patel, Pankaj ; Thakor, Advait ; Sharma, Naveen ; Walker, Tony ; Misra, Mahesh Chandra ; Gruen, Russell ; Fitzgerald, Mark. / Protocol for a prospective observational study to improve prehospital notification of injured patients presenting to trauma centres in India. In: BMJ Open. 2017 ; Vol. 7, No. 7.
@article{3912f40521d04f88bbbab7b9a90769bb,
title = "Protocol for a prospective observational study to improve prehospital notification of injured patients presenting to trauma centres in India",
abstract = "Introduction Prehospital notification of injured patients enables prompt and timely care in hospital through adequate preparation of trauma teams, space, equipment and consumables necessary for resuscitation, and may improve outcomes. In India, anecdotal reports suggest that prehospital notification, in those few places where it occurs, is unstructured and not linked to a well-defined hospital response. The aim of this manuscript is to describe, in detail, a study protocol for the evaluation of a formalised approach to prehospital notification. Methods and analysis This is a longitudinal prospective cohort study of injured patients being transported by ambulance to major trauma centres in India. In the preintervention phase, prospective data on patients will be collected on prehospital assessment, notification, inhospital assessment, management and outcomes and recorded in a new tailored multihospital trauma registry. All injured patients arriving by ambulance and allocated to a red or yellow priority category will be eligible for inclusion. The intervention will be a prehospital notification application to be used by ambulance clinicians to notify emergency departments of the impending arrival of a patient. The proportion of eligible patients arriving to hospital after notification will be the primary outcome measure. Secondary outcomes evaluated will be availability of a trauma cubicle, presence of a trauma team on patient arrival, time to first chest X-ray and inhospital mortality. Progress Ethical approval has been obtained from the All India Institute of Medical Sciences, New Delhi and site-specific approval granted by relevant trauma services. The trial has also been registered with the Monash University Human Research and Ethics Committee; Project number: CF16/1814-2016000929. Results will be fed back to prehospital and hospital clinicians via a series of reports and presentations. These will be used to facilitate discussions about service redesign and implementation. It is expected that evidence for improved outcomes will enable widespread adoption of this intervention among centres in all settings with less established tools for prehospital assessment and notification. Trial registration number NCT02877342; Pre-results.",
keywords = "Accident & Emergency Medicine, Ambulance, Notification, Trauma Management, Wounds and Injuries",
author = "Biswadev Mitra and Joseph Mathew and Amit Gupta and Peter Cameron and Gerard O'Reilly and Soni, {Kapil Dev} and Gaurav Kaushik and Teresa Howard and Madonna Fahey and Michael Stephenson and Vineet Kumar and Sharad Vyas and Satish Dharap and Pankaj Patel and Advait Thakor and Naveen Sharma and Tony Walker and Misra, {Mahesh Chandra} and Russell Gruen and Mark Fitzgerald",
year = "2017",
month = "7",
day = "1",
doi = "10.1136/bmjopen-2016-014073",
language = "English",
volume = "7",
journal = "BMJ Open",
issn = "2044-6055",
publisher = "BMJ Publishing Group",
number = "7",

}

Protocol for a prospective observational study to improve prehospital notification of injured patients presenting to trauma centres in India. / Mitra, Biswadev; Mathew, Joseph; Gupta, Amit; Cameron, Peter; O'Reilly, Gerard; Soni, Kapil Dev; Kaushik, Gaurav; Howard, Teresa; Fahey, Madonna; Stephenson, Michael; Kumar, Vineet; Vyas, Sharad; Dharap, Satish; Patel, Pankaj; Thakor, Advait; Sharma, Naveen; Walker, Tony; Misra, Mahesh Chandra; Gruen, Russell; Fitzgerald, Mark.

In: BMJ Open, Vol. 7, No. 7, e014073, 01.07.2017.

Research output: Contribution to journalArticleOtherpeer-review

TY - JOUR

T1 - Protocol for a prospective observational study to improve prehospital notification of injured patients presenting to trauma centres in India

AU - Mitra, Biswadev

AU - Mathew, Joseph

AU - Gupta, Amit

AU - Cameron, Peter

AU - O'Reilly, Gerard

AU - Soni, Kapil Dev

AU - Kaushik, Gaurav

AU - Howard, Teresa

AU - Fahey, Madonna

AU - Stephenson, Michael

AU - Kumar, Vineet

AU - Vyas, Sharad

AU - Dharap, Satish

AU - Patel, Pankaj

AU - Thakor, Advait

AU - Sharma, Naveen

AU - Walker, Tony

AU - Misra, Mahesh Chandra

AU - Gruen, Russell

AU - Fitzgerald, Mark

PY - 2017/7/1

Y1 - 2017/7/1

N2 - Introduction Prehospital notification of injured patients enables prompt and timely care in hospital through adequate preparation of trauma teams, space, equipment and consumables necessary for resuscitation, and may improve outcomes. In India, anecdotal reports suggest that prehospital notification, in those few places where it occurs, is unstructured and not linked to a well-defined hospital response. The aim of this manuscript is to describe, in detail, a study protocol for the evaluation of a formalised approach to prehospital notification. Methods and analysis This is a longitudinal prospective cohort study of injured patients being transported by ambulance to major trauma centres in India. In the preintervention phase, prospective data on patients will be collected on prehospital assessment, notification, inhospital assessment, management and outcomes and recorded in a new tailored multihospital trauma registry. All injured patients arriving by ambulance and allocated to a red or yellow priority category will be eligible for inclusion. The intervention will be a prehospital notification application to be used by ambulance clinicians to notify emergency departments of the impending arrival of a patient. The proportion of eligible patients arriving to hospital after notification will be the primary outcome measure. Secondary outcomes evaluated will be availability of a trauma cubicle, presence of a trauma team on patient arrival, time to first chest X-ray and inhospital mortality. Progress Ethical approval has been obtained from the All India Institute of Medical Sciences, New Delhi and site-specific approval granted by relevant trauma services. The trial has also been registered with the Monash University Human Research and Ethics Committee; Project number: CF16/1814-2016000929. Results will be fed back to prehospital and hospital clinicians via a series of reports and presentations. These will be used to facilitate discussions about service redesign and implementation. It is expected that evidence for improved outcomes will enable widespread adoption of this intervention among centres in all settings with less established tools for prehospital assessment and notification. Trial registration number NCT02877342; Pre-results.

AB - Introduction Prehospital notification of injured patients enables prompt and timely care in hospital through adequate preparation of trauma teams, space, equipment and consumables necessary for resuscitation, and may improve outcomes. In India, anecdotal reports suggest that prehospital notification, in those few places where it occurs, is unstructured and not linked to a well-defined hospital response. The aim of this manuscript is to describe, in detail, a study protocol for the evaluation of a formalised approach to prehospital notification. Methods and analysis This is a longitudinal prospective cohort study of injured patients being transported by ambulance to major trauma centres in India. In the preintervention phase, prospective data on patients will be collected on prehospital assessment, notification, inhospital assessment, management and outcomes and recorded in a new tailored multihospital trauma registry. All injured patients arriving by ambulance and allocated to a red or yellow priority category will be eligible for inclusion. The intervention will be a prehospital notification application to be used by ambulance clinicians to notify emergency departments of the impending arrival of a patient. The proportion of eligible patients arriving to hospital after notification will be the primary outcome measure. Secondary outcomes evaluated will be availability of a trauma cubicle, presence of a trauma team on patient arrival, time to first chest X-ray and inhospital mortality. Progress Ethical approval has been obtained from the All India Institute of Medical Sciences, New Delhi and site-specific approval granted by relevant trauma services. The trial has also been registered with the Monash University Human Research and Ethics Committee; Project number: CF16/1814-2016000929. Results will be fed back to prehospital and hospital clinicians via a series of reports and presentations. These will be used to facilitate discussions about service redesign and implementation. It is expected that evidence for improved outcomes will enable widespread adoption of this intervention among centres in all settings with less established tools for prehospital assessment and notification. Trial registration number NCT02877342; Pre-results.

KW - Accident & Emergency Medicine

KW - Ambulance

KW - Notification

KW - Trauma Management

KW - Wounds and Injuries

UR - http://www.scopus.com/inward/record.url?scp=85025104623&partnerID=8YFLogxK

U2 - 10.1136/bmjopen-2016-014073

DO - 10.1136/bmjopen-2016-014073

M3 - Article

VL - 7

JO - BMJ Open

JF - BMJ Open

SN - 2044-6055

IS - 7

M1 - e014073

ER -