Guideline on Treatment of Patients with Severe and Multiple ... - AWMF

S3 <strong>Guideline</strong> on Treatment of Patients with Severe and Multiple Injuries
Process quality for evaluation of emergency room management:
� time between hospital admission and performance of a chest X-ray in severely injured
patients (ISS ≥ 16) [∅ min ± SD]
� time between hospital admission and performance of an ultrasound scan of the
abdomen/chest in cases of severe trauma (ISS ≥ 16) [∅ min ± SD]
� time until performance of a computed tomography (CT) scan of the cranium (CCT) in prehospital
unconscious patients (GCS ≤ 8) [∅ min ± SD]
� time until performance of a full-body CT scan on all patients, if carried out [∅ min ± SD]
� time from emergency admission arrival to completion of diagnostic study in severely injured
persons if this has been completed normally (ISS ≥ 16) [∅ min ± SD]
� time from emergency admission arrival to completion of diagnostic study in severely injured
persons if this has been interrupted due to emergency (ISS ≥ 16) [∅ min ± SD]
Outcome quality for overall evaluation:
� standardized mortality rate: observed mortality divided by the expected prognosis based on
RISC (Revised Injury Severity Classification) in severely injured persons (ISS ≥ 16)
� standardized mortality rate: observed mortality divided by the expected prognosis based on
TRISS (Trauma Injury Severity Score Method) in severely injured persons (ISS ≥ 16)
The routine recording and evaluation of these data offer a vital opportunity to monitor
improvements in quality in the management of multiply injured patients and those with severe
injuries. It is not possible to ascertain from this which effects are due to the guideline. Quality
indicators should continue to be developed based on the aforementioned criteria.
B.5 Validity and updating of guideline
This guideline is valid until December 2014. The German Trauma Society is responsible for
introducing an updating process. The cooperation of the German Society of Plastic,
Reconstructive and Esthetic Surgeons (Deutsche Gesellschaft der Plastischen, Rekonstruktiven
und Ästhetischen Chirurgen) and of the German Society of Burns Medicine (Deutsche
Gesellschaft für Verbrennungsmedizin) and the thematic inclusion of burns, large skin/soft tissue
defects and nerve defect injuries (including plexus injuries) is additionally planned for this
updating.
B.6 Funding of the guideline and disclosure of potential conflicts of interests
Reimbursement monies for the methods support, costs for literature acquisition, costs for
organizing the consensus conferences, and costs of materials were provided by the German
Trauma Society and the Institute for Research in Operative Medicine (IFOM) of the University
of Witten/Herdecke. The participants’ travel costs arising from the consensus process were
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