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Team leader preparation and ATLS checklists improve completion of primary and secondary survey tasks but do not affect team leadership skills during trauma resuscitations
Daniel M. Rubalcava, MD, MSPH1, Erin B. Henkel, MD1, Esther M. Sampayo, MD, MPH1, Elizabeth A. Camp PhD1, Bindi Naik-Mathuria MD2, Corrie E. Chumpitazi MD1, David Wesson, MD2. 1Dept of Pediatrics, Section of Emergency Medicine, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA, 2Dept of Surgery, Division of Pediatric Surgery, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA.

Background: The primary and secondary survey are the backbone of patient assessment in Advanced Trauma Life Support (ATLS). A modified non-technical skills scale for trauma (T-NOTECHS) is a validated tool for assessment of leadership skills in trauma resuscitations.

Objective: To assess if team leader preparation and primary and secondary survey checklists improve team leadership skills and completion of primary and secondary survey tasks.

Methods: This study was part of a quality improvement and maintenance of certification project with the goal of improving pediatric emergency medicine (PEM) physician-led trauma resuscitations at a Level 1 pediatric trauma center. Baseline T-NOTECHS scores and percent completion of ATLS tasks were determined through video review by PEM physicians of 30 trauma resuscitations. Team leader preparation and ATLS checklists were then posted in the resuscitation room and their use was encouraged. Post-intervention,14 resuscitations were reviewed, scored, and compared to baseline.

Results: The median score for the T-NOTECHS skill of Leadership increased from baseline but there were no significant changes in the other 4 skills (Table 1). Post-intervention mean percent completion of primary survey tasks improved from 80% to 85% (p=0.03) and secondary survey tasks from 69% to 75% (p=0.02).

Conclusions: Team leader and ATLS checklists may be effective at improving the completeness of primary and secondary survey but appear to have little effect on team leadership skills.


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