SP9.1.9 Are Tertiary Trauma Surveys a worthwhile use of time and resource?

Introduction Patients sustaining major trauma undergo primary and secondary surveys in the emergency department to rapidly identify and treat injuries. Tertiary trauma surveys (TTS) are performed once the patient has been stabilised, within 24 hours of admission, to assess for further injuries. In December 2019, the major trauma service at our trauma centre was reconfigured to include a larger clinical team. Following this, we have assessed compliance with TTS completion and rate of new injuries identified. Methods Data was prospectively collected via hospital and TARN databases from 100 consecutive major trauma patients admitted over a two-month period from 1/8/20. Demographic data and key measures including, date and time of arrival to the hospital, date and time of TTS, performing clinician, injuries identified, mechanism of injury and ISS were collected. Results TTS was completed on 79/100 patients during their admission with 16.5% (13/79) of TTS performed identifying at least one additional injury. 18 separate injuries were identified which were categorized by AIS score: 22.2% AIS 1, 61.1% AIS 2 and 16.7% AIS 3. Of these injuries, 17/18 required further imaging and 3 required operative management. In 38.5% (5/13) of cases, the additional injuries increased the patients overall ISS. Conclusion This data demonstrates the importance of tertiary survey completion to ensure that all injuries sustained during major trauma are identified and treated promptly. Further development of this project will include expansion to a larger data set over a prolonged period to further evaluate the rate and significance of injuries discovered via TTS.