Although the timely involvement of trauma surgeons is widely accepted as standard care in a trauma center, there is an ongoing debate regarding the value of an on-site attending trauma surgeon compared to an on-call trauma surgeon. The aim of this study was to evaluate the effect of introducing an on-site trauma surgeons and the effect of their presence on the adherence to Advanced Trauma Life Support (ATLS) related tasks and resuscitation pace in the trauma bay. The resuscitations of severely injured (ISS > 15) trauma patients 1 month before and 1 month after the introduction of an on-site trauma surgeon were assessed using video analysis. The primary outcome was total resuscitation time. Second, time from trauma bay admission until tasks were performed, and ATLS adherence were assessed. Fifty-eight videos of resuscitations have been analyzed. After the introduction of an on-site trauma surgeon, the mean total resuscitation time was 259 seconds shorter (p = 0.03) and seven ATLS related tasks (breathing assessment, first and second IV access, EKG monitoring and abdominal, pelvic, and long bone examination; were performed significantly earlier during trauma resuscitation (p ≤ 0.05). Further, we found a significant enhancement to the adherence of six ATLS related tasks (Airway assessment, application of a rigid collar, IV access; EKG monitoring, log roll, and pronouncing results of arterial blood gas analysis; p-value ≤0.05). Having a trauma surgeon on-site during trauma resuscitations of severely injured patients resulted in improved processes in the trauma bay. This demonstrates the need of direct involvement of trauma surgeons in institutions treating severely injured patients.

中文翻译：

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现场创伤外科医生在重伤患者复苏过程中的作用

尽管创伤外科医生的及时参与被广泛接受为创伤中心的标准护理，但与待命创伤外科医生相比，现场主治创伤外科医生的价值仍存在争议。本研究的目的是评估引入现场创伤外科医生的影响以及他们的存在对坚持高级创伤生命支持 (ATLS) 相关任务和创伤湾复苏速度的影响。使用视频分析评估了在引入现场创伤外科医生之前 1 个月和之后 1 个月对严重受伤 (ISS > 15) 创伤患者的复苏情况。主要结果是总复苏时间。其次，从创伤湾入院到执行任务的时间，并评估了 ATLS 的依从性。已经分析了 58 个复苏视频。