Assistant Professor of Surgery Memorial Hermann Life Flight Houston, Texas, United States
Hemorrhage remains the leading cause of potentially preventable death in trauma patients. Multiple studies have that shown that the majority of these deaths occur within three hours of injury, and delays to operative intervention increase the risk of mortality. In an attempt to combat delays in reaching definitive hemorrhage control, Life Flight and Memorial Hermann Hospital at Texas Medical Center have developed a policy for bypassing the emergency department and proceeding directly to the operating room upon hospital arrival. This policy, which was implemented in 2018, relies on skilled assessment by air medical crews, the use of handheld ultrasound in the field for the performance of prehospital FAST examinations, and direct communication with the on-call trauma surgeon via Life Flight dispatchers. Activation of the Helipad to OR protocol also automatically activates the hospital's massive transfusion protocol. Typically, the first MTP cooler arrives in the OR even before the patient arrives. This protocol helps to eliminate time unnecessary time spent in the ED and decrease the time to definitive hemorrhage control.
Learning Objectives:
Describe the history of bypassing the ED in trauma
Identify stakeholders in the protocol development process and list indications for bypassing the ED
Describe the Life Flight/MHH protocol for bypassing the ED and list the benefits and drawbacks to bypassing the ED.
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.jpg "David E. Meyer, MD photo")