Where to next? Development and implementation of the “Radiology Trauma Primary Survey” at a tertiary paediatric trauma centre

Abstract

Purpose: To describe the development and implementation of the Radiology Trauma Primary Survey (RTPS) at a tertiary paediatric trauma centre. The RTPS communicates preliminary imaging findings in paediatric multi-trauma CT cases, prior to the release of a formal detailed CT report. Methods and Materials: The RTPS was developed for use in a paediatric trauma population. Due to the differing injury patterns in children1, a paediatric specific survey was devised, following review of existing documents used in adult trauma2. The purpose of the RTPS is to identify, document and communicate major radiological findings to guide the initial disposition and management of trauma patients requiring multiregional CT assessment. This helps bridge a communication gap in the pathway of trauma management between image acquisition and formal CT report completion. Image interpretation and RTPS completion occurred at the CT scanner by Radiologists and Radiology trainees. The hard copy worksheet accompanied the trauma team and patient, with a soft copy available on PACS. The RTPS was trialed over a 12 month period during 2019, in paediatric trauma patients requiring multiregional CT assessment at Queensland Children's Hospital (QCH). SurveyMonkey was used to obtain feedback from stakeholders including Emergency specialists/ trainees, Radiology specialists/trainees and Radiographers. Results: 43 stakeholders completed the SurveyMonkey. 34 of 41 found it assisted with communication in patient management; 35 of 41 found the RTPS overall useful and necessary; 41 of 41 did not view this RTPS as equivalent to the finalised report; 34 of 41 found the RTPS did not include any inappropriate/unnecessary points; 11 of 41 had suggestions of further information that could be added to the RTPS. The RTPS was modified to reflect the feedback and has been adopted for use in QCH trauma patients. Conclusion: We describe the successful development and implementation of the RTPS to communicate preliminary imaging findings in trauma CT cases at a tertiary paediatric trauma centre. The RTPS was found to be of value in communicating preliminary imaging findings in paediatric trauma patients. This tool effectively addresses gaps in communication and assists rapid patient disposition and management.L6361334762021-10-07 <br />