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Prehospital trauma death review in the State of Victoria, Australia: a study protocol
  1. Eric Mercier1,2,
  2. Peter A Cameron1,3,
  3. Karen Smith1,4,5,
  4. Ben Beck1,2
  1. 1 Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
  2. 2 Faculty of Medicine, Laval University, Quebec City, Quebec, Canada
  3. 3 Emergency and Trauma Centre, The Alfred, Melbourne, Victoria, Australia
  4. 4 Center for Research and Evaluation, Ambulance Victoria, Doncaster, Victoria, Australia
  5. 5 Department of Community Emergency Health and Paramedic Practice, Monash University, Melbourne, Victoria, Australia
  1. Correspondence to Dr Ben Beck; ben.beck{at}monash.edu

Abstract

Introduction Regionalised trauma systems have been shown to improve outcomes for trauma patients. However, the evaluation of these trauma systems has been oriented towards in-hospital care. Therefore, the epidemiology and care delivered to the injured patients who died in the prehospital setting remain poorly studied. This study aims to provide an overview of a methodological approach to reviewing trauma deaths in order to assess the preventability, identify areas for improvements in the system of care provided to these patients and evaluate the potential for novel interventions to improve outcomes for seriously injured trauma patients.

Methods and analysis The planned study is a retrospective review of prehospital and early in-hospital (<24 hours) deaths following traumatic out-of-hospital cardiac arrest that were attended by Ambulance Victoria between 2008 and 2014. Eligible patients will be identified from the Victorian Ambulance Cardiac Arrest Registry and linked with the National Coronial Information System. For patients who were transported to hospital, data will be linked the Victoria State Trauma Registry. The project will be undertaken in four phases: (1) survivability assessment; (2) preventability assessment; (3) identification of potential areas for improvement; and (4) identification of potentially useful novel technologies. Survivability assessment will be based on predetermined anatomical injuries considered unsurvivable. For patients with potentially survivable injuries, multidisciplinary expert panel reviews will be conducted to assess the preventability as well as the identification of potential areas for improvement and the utility of novel technologies.

Ethics and dissemination The present study was approved by the Victorian Department of Justice and Regulation HREC (CF/16/272) and the Monash University HREC (CF16/532 – 2016000259). Results of the study will be published in peer-reviewed journals and reports provided to Ambulance Victoria, the Victorian State Trauma Committee and the Victorian State Government Department of Health and Human Services.

  • trauma
  • prehospital trauma death
  • traumatic injuries
  • injury prevention
  • survivability
  • outcome assessment

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Footnotes

  • Contributors This study protocol was developed by all authors. EM and BB prepared the first draft of this summary protocol paper and revised in light of comments from PAC and KS. All authors approved the final version of the manuscript.

  • Funding This project has been funded by the RACV Safety Research Fund, the Victorian State Government Department of Health and Human Services, the Royal Australasian College of Surgeons (RACS) Foundation of Surgery and the Australian Resuscitation Council (Victorian Branch). BB received salary support from the National Health and Medical Research Council (NHRMC) Australian Resuscitation Outcomes Consortium (Aus-ROC) Centre of Research Excellence (#1029983). PAC was supported by a Practitioner Fellowship (#545926) from the NHMRC.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval The Victorian Ambulance Cardiac Arrest Registry has approval from the Victorian Department of Health and Human Services Human Research Ethics Committee (HREC) (No. 08/02). The Victoria State Trauma Registry has approval from the Victorian Department of Health and Human Services HREC for 138 trauma-receiving hospitals in Victoria (DHHREC 11/14) and the Monash University HREC (CF13/3040 – 2001000165). The present study was approved by the Victorian Department of Justice and Regulation HREC (CF/16/272), the Monash University HREC (CF16/532 – 2016000259), the Ambulance Victoria Research Committee and the Victorian State Trauma Outcomes Registry Monitoring Group.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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