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Asking a Better Question: Development and Evaluation of the Need For Trauma Intervention (NFTI) Metric as a Novel Indicator of Major Trauma

doi: 10.1097/JTN.0000000000000292
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Back to Top | Article Outline


General Purpose Statement: To describe the development and evaluation of the Need For Trauma Intervention (NFTI) metric as an indicator of major trauma.

Learning Objectives/Outcomes: After completing this continuing education activity, you should be able to:

  1. Describe the need for a metric to identify major trauma and the development of the NFTI.
  2. Explain the results and clinical implications of the study evaluating the NFTI metric as an indicator of major trauma.
  1. The definition of major trauma is typically based on
    1. anatomic injury severity.
    2. mechanism of injury.
    3. physiologic injury severity.
  2. As described by Baxt and Upenieks (1990), one limitation of the Injury Severity Score (ISS) is its limited association with
    1. changes in consciousness.
    2. resource consumption and outcomes.
    3. age of the patient.
  3. Research by McMahon et al. (1996) found the worst ISS performance in which traumas?
    1. geriatric
    2. pediatric
    3. young adults
  4. The American College of Surgeons, Committee on Trauma recommends making over- and undertriage determinations using the ISS cutoff along with
    1. patient age.
    2. case review.
    3. Glasgow Coma Scale score.
  5. The creation of the NFTI metric was based on acute-phase resource utilization and
    1. age.
    2. physiological indicators.
    3. survival.
  6. The NFTI measures
    1. early complications.
    2. late complications.
    3. resource consumption.
  7. The NFTI self-adjustment assumes that care teams adjust treatments to account for
    1. resource availability.
    2. mechanism of traumatic injury.
    3. age, frailty, comorbidities, and physiology.
  8. One of the NFTI criteria is the patient receiving, within the first 4 hr of arrival,
    1. corticosteroids.
    2. packed red blood cells.
    3. 2 L of a crystalloid solution.
  9. NFTI criteria include having a total intensive care unit (ICU) length of stay of
    1. 48 hr or more.
    2. at least seven calendar days.
    3. three or more calendar days.
  10. Statistical analysis showed that being NFTI+ was significantly associated with
    1. blunt trauma.
    2. older age.
    3. lower initial emergency department pulse.
  11. Compared with an ISS cutoff of greater than 15, for overall mortality and mortality after 60 hr, NFTI had better
    1. sensitivity.
    2. specificity.
    3. usability.
  12. As stated by Rotondo et al. (2014), a trauma center's accepted rate of overtriage is no more than
    1. 5%.
    2. 20%.
    3. 35%.
  13. What method does the NFTI metric use to incorporate the treatment of injury pathophysiology?
    1. a checklist of care resource consumption
    2. direct measurement of anatomic injuries
    3. standardized trauma scales and scores
  14. On measures of physiology, meeting NFTI criteria was associated with
    1. higher mean arterial pressure.
    2. faster pulse.
    3. lower ISS.
  15. Most importantly, meeting NFTI criteria was associated with
    1. comorbidities.
    2. late complications.
    3. mortalities.
  16. Using the National Trauma Data Standard definition of ICU length of stay, an ICU admission at 11:59 p.m. that lasts for 2 min would be counted as
    1. 1 hr.
    2. one night.
    3. two calendar days.
  17. Regarding data collection, one of the goals of NFTI was to
    1. create new trauma-specific variables.
    2. improve widely used measurement protocols.
    3. use defined variables that most centers already collect.
  18. Which question does the NFTI metric ask?
    1. Did the patient actually need a trauma activation?
    2. How severely injured was the patient?
    3. Was the treatment intervention effective?
Copyright © 2017 by the Society of Trauma Nurses.