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      Effect of an Emergency Medicine Resident as Team Leader on Outcomes of Trauma Team Activations

      research-article
      , MD (Cand. 2018), MSc 1 , , PhD, MHI 2 , , MD, DABEM, FRCPC, FRCP (Edin) 1 , 2 ,
      , MD
      AEM Education and Training
      John Wiley and Sons Inc.

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          Abstract

          Objectives

          Traditionally, a surgeon has served as trauma team leader ( TTL). However, this role is increasingly being performed by emergency medicine ( EM) physicians. At the Halifax Infirmary, we utilize a resident TTL ( rTTL) under supervision of a staff traumatologist, a duty shared between EM and surgical residents. Our objective was to compare outcomes between cases led by EM and surgical rTTLs.

          Methods

          This was a retrospective case–control study of data collected from the Nova Scotia Trauma Registry. Eligible cases were attended to by the trauma team from April 4, 2014, to March 31, 2015. Primary outcome of interest was in‐hospital mortality. Secondary outcomes included hospital admission, hospital length of stay ( LOS), intensive care unit ( ICU) admission, ICU LOS, ventilator requirement, operating room use, and time to operating room. Univariate comparisons were made using t‐tests and Fisher's test. We used logistic and linear regression to adjust for confounding.

          Results

          A total of 571 patients were included in the analysis. A total of 179 (31.3%) were managed by an EM resident and the remainder were managed by a surgical resident. There was no statistical difference in mortality or secondary outcomes on the crude or adjusted estimates. Eighteen patients (10.1%) in the EM group died compared to 37 (9.4%) in the surgical group.

          Conclusions

          There was no difference in any patient outcome between cases managed by EM and surgical rTTLs. These findings support the philosophy that both groups are effective as rTTLs and should be trained in trauma leadership. Further research is warranted in introducing the rTTL into other systems.

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          Author and article information

          Contributors
          greenrs@dal.ca
          Journal
          AEM Educ Train
          AEM Educ Train
          10.1002/(ISSN)2472-5390
          AET2
          AEM Education and Training
          John Wiley and Sons Inc. (Hoboken )
          2472-5390
          08 February 2018
          April 2018
          : 2
          : 2 ( doiID: 10.1002/aet2.2018.2.issue-2 )
          : 107-114
          Affiliations
          [ 1 ] Department of Critical Care Dalhousie University Halifax NS Canada
          [ 2 ] Trauma Nova Scotia Nova Scotia Department of Health and Wellness Halifax NS Canada
          Author notes
          [*] [* ]Address for correspondence and reprints: Robert S. Green; e‐mail: greenrs@ 123456dal.ca .
          Article
          PMC6001507 PMC6001507 6001507 AET210082
          10.1002/aet2.10082
          6001507
          30051077
          89537918-ecb8-477b-97a6-6eb7183c0a6d
          © 2018 by the Society for Academic Emergency Medicine
          History
          : 02 June 2017
          : 09 November 2017
          : 20 December 2017
          Page count
          Figures: 1, Tables: 3, Pages: 8, Words: 4964
          Funding
          Funded by: Faculty of Medicine, Dalhousie University
          Categories
          Original Contribution
          Original Contributions
          Custom metadata
          2.0
          aet210082-081
          April 2018
          Converter:WILEY_ML3GV2_TO_NLMPMC version:version=5.4.1.1 mode:remove_FC converted:14.06.2018

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