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Menchetti I, Muzzo M, Malo C, Ackery A, Nemeth J, Rao J, Engels PT, Vogt K, Razek T, Beckett A, da Luz L. Who are the trauma team leaders across Canada? A national survey evaluating the profession in adult and pediatric level one trauma centres. CAN J EMERG MED 2023; 25:959-967. [PMID: 37853308 DOI: 10.1007/s43678-023-00607-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 09/26/2023] [Indexed: 10/20/2023]
Abstract
OBJECTIVES Trauma Team Leaders (TTLs) are critical for coordinating and leading trauma resuscitations. This survey sought to characterize the demographics and professional practices of Canadian TTLs at level one trauma centres. As a secondary objective, this information will be utilized to inform the operational goals of the Trauma Association of Canada (TAC) TTL Committee. METHODS A detailed survey, developed by the TAC board of directors and TTL committee leads, was sent to 225 TTLs across Canada's level one trauma centres. TTLs were identified via contacting trauma directors at each level one centre, in addition to public registry searches. This survey captured demographics, professional background, resuscitation practices, trauma team composition, and TTL involvement in trauma responses. RESULTS The response rate was 41.7%. Mean respondent age was 42 (SD 7.4) and 71.0% were male. Most TTLs trained in emergency medicine (53.1%) or general surgery (25.5%); 63.8% underwent TTL training: either via a trauma surgery fellowship or TTL fellowship. All centres have a massive hemorrhage protocol implemented, and there is no large variation between the rates of use of cryoprecipitate and fibrinogen, nor the ratio of blood products transfused (2:1 vs 1:1). Most TTL respondents intend to participate in a TTL group associated with TAC (85.1%). CONCLUSION The results of this survey will contribute to the recognition of TTLs as a crucial role in the initial phase of care of severely injured trauma patients and serves as the first publication to document professional backgrounds and practices of Canadian TTLs at level one trauma centres. All the information gathered via this survey will be used by the TAC TTL Committee, which will focus on several initiatives such as the dissemination of best practice guidelines and creation of a TTL stream at the TAC Annual Conference.
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Affiliation(s)
- Isabella Menchetti
- Department of Emergency Medicine, University of Ottawa, The Ottawa Hospital, Ottawa, ON, Canada.
| | - Madison Muzzo
- Department of Neuroscience, Northeastern University, Boston, MA, USA
| | - Christian Malo
- Department of Emergency Medicine, CHU de Québec-Université Laval, Quebec, QC, Canada
| | - Alun Ackery
- Department of Emergency Medicine, St Michael's Hospital, Toronto, ON, Canada
| | - Joe Nemeth
- Department of Emergency Medicine, McGill University, Montreal, QC, Canada
| | - Jagadish Rao
- Department of Surgery, University of Saskatchewan, Regina, SK, Canada
| | - Paul T Engels
- Department of Surgery, McMaster University, Hamilton, ON, Canada
| | - Kelly Vogt
- Department of Surgery, London Health Sciences Centre, London, ON, Canada
| | - Tarek Razek
- Department of Surgery, McGill University, Montreal, QC, Canada
| | - Andrew Beckett
- Department of General Surgery, St Michael's Hospital, Toronto, ON, Canada
| | - Luis da Luz
- Department of General Surgery, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
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Hong ZJ, Chen CJ, Chan DC, Chen TW, Yu JC, Hsu SD. Experienced trauma team leaders save the lives of multiple-trauma patients with severe head injuries. Surg Today 2018; 49:261-267. [PMID: 30302552 DOI: 10.1007/s00595-018-1723-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Accepted: 09/29/2018] [Indexed: 11/25/2022]
Abstract
The trauma team leader is a professional who receives and treats trauma patients. We aimed to evaluate whether or not the seniority of a qualified trauma team leader was a prognostic factor for multiple-trauma patients managed by a trauma team. This was a retrospective cohort study conducted at a Level I Trauma Center in North Taiwan. From January 2009 to December 2013, 284 patients were randomly assigned to one of two trauma team leaders (junior and senior leaders) on duty, irrespective of the seniority of the qualified trauma team leader. All parameters were collected and compared between these two groups. In the subgroup of multiple-trauma patients with Glasgow Coma Scale (GCS) ≤ 8, there were significant differences in the injury severity score, revised trauma score, and seniority of the leader between the alive and dead groups. A multivariate logistic regression analysis showed that the seniority of the trauma team leader was an important mortality risk factor [odds ratio (OR): 14.529, 95% confidence interval (CI) 1.683-125.429, p = 0.015] in patients with GCS ≤ 8. However, in patients with GCS > 8, age was the only independent risk factor [OR: 1.055, 95% CI 1.023-1.087, p = 0.001]. The seniority of the qualified trauma leader is important for teamwork, organization, and efficiency, all of which play an important role in improving the survival outcome of patients with GCS ≤ 8.
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Affiliation(s)
- Zhi-Jie Hong
- Division of General Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.,Division of Trauma Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.,Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Cheng-Jueng Chen
- Division of General Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.,Division of Trauma Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
| | - De-Chuan Chan
- Division of General Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Teng-Wei Chen
- Division of General Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Jyh-Cherng Yu
- Division of General Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Sheng-Der Hsu
- Division of General Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC. .,Division of Trauma Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC. .,Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, 325, Sec 2, Chen-Kung Rd, Neihu 114, Taipei, Taiwan, ROC.
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Johnsen BH, Westli HK, Espevik R, Wisborg T, Brattebø G. High-performing trauma teams: frequency of behavioral markers of a shared mental model displayed by team leaders and quality of medical performance. Scand J Trauma Resusc Emerg Med 2017; 25:109. [PMID: 29126452 PMCID: PMC5681813 DOI: 10.1186/s13049-017-0452-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 10/24/2017] [Indexed: 11/10/2022] Open
Abstract
Background High quality team leadership is important for the outcome of medical emergencies. However, the behavioral marker of leadership are not well defined. The present study investigated frequency of behavioral markers of shared mental models (SMM) on quality of medical management. Method Training video recordings of 27 trauma teams simulating emergencies were analyzed according to team -leader’s frequency of shared mental model behavioral markers. Results The results showed a positive correlation of quality of medical management with leaders sharing information without an explicit demand for the information (“push” of information) and with leaders communicating their situational awareness (SA) and demonstrating implicit supporting behavior. When separating the sample into higher versus lower performing teams, the higher performing teams had leaders who displayed a greater frequency of “push” of information and communication of SA and supportive behavior. No difference was found for the behavioral marker of team initiative, measured as bringing up suggestions to other teammembers. Conclusion The results of this study emphasize the team leader’s role in initiating and updating a team’s shared mental model. Team leaders should also set expectations for acceptable interaction patterns (e.g., promoting information exchange) and create a team climate that encourages behaviors, such as mutual performance monitoring, backup behavior, and adaptability to enhance SMM.
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Affiliation(s)
- Bjørn Helge Johnsen
- Department of Psychosocial Science, University of Bergen, Christiesgt 12, 5015, Bergen, Norway.
| | | | - Roar Espevik
- The Royal Norwegian Naval Academy, Bergen, Norway
| | - Torben Wisborg
- Anesthesia and Critical Care Research Group, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway
| | - Guttorm Brattebø
- Department of Anesthesia and Intensive Care, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Medicine, University of Bergen, Bergen, Norway.,Norwegian National Advisory Unit on Trauma, Oslo University Hospital, Oslo, Norway
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