Practice Patterns and Management Protocols in Trauma across Indian Settings: A Nationwide Cross-sectional Survey

JOURNAL TITLE: Indian Journal of Critical Care Medicine

Author
1. Shrikant Sahasrabudhe
2. Ruchira Wasudeo Khasne
3. Venkat Raman Kola
4. Pramod Sood
5. Prasad Anant Rajhans
6. Ankur R Bhavsa
7. Manender Kumar
8. Pragyan Kumar Routray
9. Ganshyam Jagathkar
10. Reshu Gupta
11. Amrish Patel
12. Kanwalpreet Sodhi
13. Rajesh C Mishra
14. Gunjan Chanchalani
15. Mahesh Mishra
ISSN
0972-5229
DOI
10.5005/jp-journals-10071-24384
Volume
27
Issue
1
Publishing Year
2023
Pages
14
Author Affiliations
    1. Department of Critical Care Medicine, SMBT Institute of Medical Sciences and Research Centre, Dhamangaon, Igatpuri, Nashik, Maharashtra, India
    1. Department of Critical Care, MaxCure Hospitals, Hyderabad, Telangana, India
    1. Department of Critical Care, Yashoda Hospitals, Hyderabad, Telangana, India
    1. Medicover Hospitals, Aurangabad, Maharashtra, India
    1. Sterling Hospital, Ahmedabad, Gujarat, India
    2. Ahmedabad, Gujarat, India
    3. Sterling Hospital Ahmedabad, Gujarat, India
    1. Department of Critical Care, Spandan Multispeciality Hospital, Vadodara, Gujarat, India
    1. Department of Critical Care, CARE Hospitals, Bhubaneswar, Odisha, India
    1. Critical Care Division, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
    1. Department of Critical Care and Emergency Medicine, Deenanath Mangeshkar Hospital, Pune, Maharashtra, India
    1. Department of Physiology, Rajasthan University of Health Sciences College of Medical Sciences, Kumbha Marg, Jaipur, Rajasthan, India
    1. Hero DMC Heart Institute Dayanand Medical College, Ludhiana, Punjab, India
    2. Fortis Hospital, Ludhiana, Punjab, India
  • Article keywords
    Advanced trauma life support-trained emergency room physician, e-FAST, Trauma, Trauma center, Trauma code, Trauma team

    Abstract

    Background: Trauma is the leading cause of death in India resulting in a significant public health burden. Indian Society of Critical Care Medicine (ISCCM) has established a trauma network committee to understand current practices and identify the gaps and challenges in trauma management in Indian settings. Material and methods: An online survey-based, cross-sectional, descriptive study was conducted with high-priority research questions based on hospital profile, resource availability, and trauma management protocols. Results: Data from 483 centers were analyzed. A significant difference was observed in infrastructure, resource utilization, and management protocols in different types of hospitals and between small and big size hospitals across different tier cities in India (p < 0.05). The advanced trauma life support (ATLS)-trained emergency room (ER) physician had a significant impact on infrastructure organization and trauma management protocols (p < 0.05). On multivariate analysis, the highest impact of ATLS-trained ER physicians was on the use of extended focused assessment with sonography in trauma (eFAST) (2.909 times), followed by hospital trauma code (2.778 times), dedicated trauma team (1.952 times), and following trauma scores (1.651 times). Conclusion: We found that majority of the centers are well equipped with optimal infrastructure, ATLS-trained physician, and management protocols. Still many aspects of trauma management need to be prioritized. There should be proactive involvement at an organizational level to manage trauma patients with a multidisciplinary approach. This survey gives us a deep insight into the current scenario of trauma care and can guide to strengthen across the country.

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