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Effect of an Emergency Medicine Resident as Team Leader on Outcomes of Trauma Team Activations
Author(s) -
Butler Michael B.,
Erdogan Mete,
Green Robert S.
Publication year - 2018
Publication title -
aem education and training
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 9
ISSN - 2472-5390
DOI - 10.1002/aet2.10082
Subject(s) - medicine , emergency medicine , logistic regression , intensive care unit , confounding , univariate analysis , retrospective cohort study , medical emergency , multivariate analysis , surgery , intensive care medicine
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 rTTL s. 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 rTTL s. These findings support the philosophy that both groups are effective as rTTL s and should be trained in trauma leadership. Further research is warranted in introducing the rTTL into other systems.