1 / 23

Emergency Management of Pelvic Fractures: An audit of practice before and after MTC status

Emergency Management of Pelvic Fractures: An audit of practice before and after MTC status. Jonathan Barnes, Ramsey Refaie, Philip Thomas, Andrew Gray. Royal Victoria Infirmary, Newcastle Upon Tyne, 2012-2014. Introduction. Background Methods Results Discussion. Pelvic Fractures.

damara
Télécharger la présentation

Emergency Management of Pelvic Fractures: An audit of practice before and after MTC status

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Emergency Management of Pelvic Fractures: An audit of practice before and after MTC status Jonathan Barnes, Ramsey Refaie, Philip Thomas, Andrew Gray Royal Victoria Infirmary, Newcastle Upon Tyne, 2012-2014

  2. Introduction • Background • Methods • Results • Discussion

  3. Pelvic Fractures

  4. Pelvic Fractures • Pelvic injuries associated with major trauma • Associated injuries

  5. Pelvic Fractures

  6. Pelvic Fractures • Pelvic injuries associated with major trauma • Associated injuries • Highly vascularised/multiple viscera • Risk of major haemorrhage/organ damage • High mortality/morbidity • CT more sensitive than X-Ray

  7. Pelvic Binders • Pelvic Stabilisation • Reduce fracture • Tamponade bleed • Facilitate transfer Quick, cheap, simple Applied to all suspected pelvic fractures Applied at greater trochanters (or just below)

  8. Question: “How well are we using pelvic binders?” “How are we investigating patients?” “Has MTC status changed this?”

  9. Major Trauma Centre • Centralised services • Consultant led, access to surgery/radiology, major trauma protocol • RVI: • Northeast MTC • Adults/paeds • “Could save 450-600 lives per year” • MTC = increased workload, improved practice

  10. Methods • Retrospective cohort analysis • All ED admission with pelvic # • Six months before/after MTC status • Six months one year on • Reviewed imaging: • Imaging type? • Pelvic binder? • Accurate placement

  11. Methods • Accurate placement • Binder at level of greater trochanters • Exclusions • Isolated pubic ramus fractures • Transfers

  12. Results Total admissions and binder application rates before and after MTC status * Total Admissions Number of Patients Patients with binder Pre MTC Status Post MTC (0-6m) Post MTC (12-18m)

  13. Results Total admissions and binder application rates before and after MTC status * Total Admissions Number of Patients Patients with binder Pre MTC Status Post MTC (0-6m) Post MTC (12-18m)

  14. Results Total admissions and binder application rates before and after MTC status * Total Admissions Number of Patients Patients with binder Pre MTC Status Post MTC (0-6m) Post MTC (12-18m)

  15. Results Total admissions and binder application rates before and after MTC status * Total Admissions Number of Patients Patients with binder Pre MTC Status Post MTC (0-6m) Post MTC (12-18m)

  16. Results Total admissions and binder application rates before and after MTC status * Total Admissions Number of Patients Patients with binder Pre MTC Status Post MTC (0-6m) Post MTC (12-18m) * = p < 0.05

  17. Results • Binder accuracy: • Before MTC – 80% • After MTC (0-6m) – 92.4% • After MTC (12-18m) – 100%

  18. Results CT Scan X-Ray Pre MTC Status Post MTC (0-6m) Post MTC (12-18m)

  19. Results CT Scan X-Ray Pre MTC Status Post MTC (0-6m) Post MTC (12-18m)

  20. Results CT Scan X-Ray * Pre MTC Status Post MTC (0-6m) Post MTC (12-18m) * = p < 0.05

  21. Conclusions • Pelvic fractures = major trauma • Pelvic binders – simple and effective • More pelvic # post MTC • Triage protocols • More major trauma

  22. Conclusions • Increased use of CT scan • Increased availability • Increased ED experience • More binders post MTC • Not immediate effect – learning curve • ?Increased ambulance availability/experience • ?Increased ED experience • Increased accuracy of binder placement

  23. Thank you! Thank you

More Related