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Lower extremity vascular trauma protocol can improve patient care
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Initiation of a lower-extremity vascular trauma protocol improved flow of care, enabling staff surgeons to better address and care for vascular injuries in pediatric patients, according to study results.
Researchers initiated a lower-extremity vascular trauma protocol (LEVP) among 22 patients who presented with an ischemic lower extremity requiring urgent management. Main outcome measurements of the study included treatment team expertise, time to revascularization and use of time-delaying preoperative radiographic vascular studies performed before and after initiation of LEVP.
Results showed before the initiation of the LEVP, the mean time from admission to definitive operative vascular care was 6.4 hours, with 20% of cases having revascularization procedures performed more than 8 hours after presentation; however, after LEVP implementation, mean time to vascular care was 4.6 hours, and 0% of cases had revascularization.
The researchers found 37.5% of patients had a preoperative diagnostic radiographic vascular study before LEVP initiation vs. 0% after protocol initiation. Before LEVP initiation, 50% of patients were treated by children’s hospital staff, 44% by physicians consulted from an adjacent adult hospital and 6% were transferred to the adult hospital for vascular care, according to study results. However, the researchers found all lower-extremity vascular injuries were treated by lower-extremity microvascular repair-capable adult reconstruction plastic surgeons after protocol initiation. – by Casey Tingle
Disclosure: The researchers report no relevant financial disclosures.
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