The STRAUMA Protocol: A Multidisciplinary Approach to Improving the Time it Takes to Receive Critical Treatment
Chance Swanson1, Joshua Justice2, Michelle Luschen3, Jordan Rahm4, Bailey Segura5, Darrell Hunt5
1Thomas F. Frist Jr., College of Medicine, 2Department of Emergency Medicine, 3Department of Radiology, TriStar Skyline Medical Center, 4Graduate Medical Education, TriStar Division, HCA, 5Department of Surgery, Division of Trauma, Tristar Skyline Medical Center
Objective:
Our study sought to find a difference in the time it took to receive a computed tomography (CT) scan of the head for STRAUMA patients.
Background:
The STRAUMA alert is a protocol that combines elements of a stroke and trauma alert that allows assessment from a multidisciplinary perspective without a delay in providing critical treatments in a timely manner. 
Design/Methods:

The time it took to receive tissue plasminogen activator (tPA) was measured, along with the number of diagnosed strokes among these groups. Data was collected retrospectively from a State-designated Level I Trauma facility and a Comprehensive Stroke Facility. Door-to-CT time was compared between STRAUMA (n=24), stroke (n=120), and trauma (n=144) patients. The number of diagnosed strokes was also compared among these three groups.

 

Results:

Door-to-CT head times were significantly longer for the trauma group when compared to both the stroke and the STRAUMA groups, p=0.0000016.  While the median door-to-CT head time was longer in the STRAUMA group, it was not significantly different to the stroke group, p=0.12. The trauma group was more severely injured than the STRAUMA group, p=0.000000028. The stroke group patients had more severe stroke presentation than the STRAUMA group (p=.0068) on the NIHSS. Glasgow coma scale scores and modified Rankin scores were similar between the STRAUMA and stroke group. The difference in percentage of diagnosed strokes between the STRAUMA and stroke group was not significant (p=0.30). For those patients diagnosed with ischemic stroke, the median time from diagnosis till tPA administration was similar between the STRAUMA group and the stroke group, p=0.36.

Conclusions:

According to our results the STRAUMA alert has been able to provide a thorough assessment to patients without delaying times to standard measures. These findings can lend support to widespread use of the STRAUMA alert in hospitals to provide patients with comprehensive care.

10.1212/WNL.0000000000213312
Disclaimer: Abstracts were not reviewed by Neurology® and do not reflect the views of Neurology® editors or staff.