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News: App Gives ED Staff Heads-Up on Trauma Patients

Katz, Alissa

doi: 10.1097/01.EEM.0000465949.33603.09
News
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A new app allows Iowa state troopers to send photos of damaged vehicles to EDs to give staff a better idea of the severity of patients' injuries before they arrive, according to the University of Iowa (UI) Public Policy Center (http://bit.ly/1JHadqC.)

The TraumaHawk app allows emergency physicians and nurses to prepare rooms, equipment, and personnel before the ambulance makes a preliminary medical report. Through the app, which was developed in cooperation with staff at the UI's National Advanced Driving Simulator and with the sponsorship of the Iowa Department of Transportation, a pilot program has helped increase the average warning time to 31 minutes. It requires the trooper to provide basic information about the type of vehicle and the areas of damage, and then respond to a series of automatic prompts about the crash scene. Those prompts then show the officers what type of photos are required, down to demonstrating the angles at which the photos should be taken.

“The goal of TraumaHawk is to understand injury mechanism from car crashes. By getting specific photo angles of the crush patterns and intrusion into the vehicle, we can begin to predict what some of the injuries might be,” said Dan McGehee, PhD, the project's principal investigator, the director of the Human Factors and Vehicle Safety Research Division at the UI Public Policy Center, and an adjunct professor of emergency medicine and mechanical/industrial engineering at UI.

Because of privacy and other legal concerns, the troopers participating in the pilot program have a separate iPhone dedicated to the TraumaHawk app. The images are sent to a secure email server, which is accessible by the researchers, and appear on a dedicated iPad in the hospital trauma unit.

Researchers originally planned for the app to be used by paramedics at crash scenes, but early studies found that paramedics were too busy to do anything other than tend to the victims. State troopers, however, are winding down their some of responsibilities after the medical responders arrive on the scene.

“ALS paramedics are often too busy to call in, and consequently, the ED may only have a few minutes' notice. This is important to emergency medicine in general because it provides data around injury mechanism rather than the status of the patient,” Dr. McGehee said.

As part of the outcomes research, trauma alerts and activation pages were examined for estimated time of arrival (ETA) data for a one-month period at the initial release of the TraumaHawk app, and timing for the TraumaHawk alerts during the same time period relative to actual ETA was also examined. For TraumaHawk cases received between October 2013 and June 2014, electronic medical records, trauma alert, and activation pages were examined for time of trauma alert/activation page and actual time of patient arrival.

Thirty-five TraumaHawk cases were identified during the study period, 32 of which met trauma alert or activation criteria. Of these 32, the actual mean time between the trauma team page and patient arrival was 12 minutes. Using TraumaHawk, EDs received advanced notice 26 minutes before patient arrival, more than doubling notification time.

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