The Impact of the Tertiary Survey in an Established Trauma Program. Issue 3 (March 2021)

• Record Type: Journal Article
• Authors: Mitchell, Brendan P.; Stumpff, Kelly; Berry, Stepheny; Howard, James; Bennett, Ashley; Winfield, Robert D.
• Is Part Of: American surgeon. Volume 87:Issue 3(2021)
• Page Start: 437
• Page End: 442
• Publication Date: 2021-03
• Subjects: tertiary survey -- missed injury -- trauma quality improvement; Surgery -- Periodicals; Surgery -- United States -- Periodicals; 617.0973
• DOI: 10.1177/0003134820951449
• Languages: English
• ISSNs: 0003-1348

Abstract

Introduction: The trauma tertiary survey (TTS) was first described in 1990 and is recognized as an essential practice in trauma care. The TTS remains effective in detecting secondary injuries in the modern era. Methods: Trauma patients discharged between August 1, 2016, and December 31, 2016, were identified in our trauma registry. Collected data include TTS completion rates, detection of injuries, type of provider, and timing. TTS documentation was qualitatively evaluated. Results: Out of 407 patients, 264 patients (65%) received a TTS. Injury detection rate was 1.1.%. Average time to TTS was 41 hours. TTS were completed by resident physicians (46%) and advanced practice providers (APPs; 46%). TTS documentation was more complete for APPs than for resident physicians. Conclusion: TTS remains an integral component of modern trauma care. Ongoing education on the significance of TTS and the importance of thorough documentation is essential. Provision of real-time feedback to providers is also critical for improving current practices.