Table 2

All processed audit filters, source group and final scores at both sites (rejected filters are italic)

Group*IDAudit filterScore†SiteModified‡
WHO3.1Hourly GCS in the emergency department of trauma patients with a diagnosis of skull fracture, intracranial injury or spinal cord injury.10.01Yes
3.2Sequential (every 30 min) GCS of trauma patients with a diagnosis of skull fracture, intracranial injury or spinal cord injury.10.02Yes
5Documentation of history and physical examination by a doctor.10.01No
10.02No
6.1Head CT scan done within 2 hours of arrival at hospital for a non-transferred patient with Glasgow Coma Scale score <13 and systolic blood pressure >90.6.51No
6.2Head CT scan done within 2 hours of arrival at hospital for a non-transferred patient with Glasgow Coma Scale score <8 and systolic blood pressure >90.10.02Yes
14Operative treatment of gunshot wound to the abdomen.9.01No
10.02No
15.1Fixation of femoral fracture in an adult patient within 24 hours of arrival to emergency department.6.51No
15.2Fixation of isolated closed femoral shaft fracture in an adult patient within 24 hours of arrival to emergency department.7.02Yes
LMIC21.1Vital signs recorded within 5 min of arrival to emergency department (must include breathing assessment, heart rate, blood pressure, oxygen saturation if available).10.01Yes
21.2Vital signs recorded within 5 min of arrival to emergency department (must include breathing assessment, heart rate, blood pressure, oxygen saturation).10.02Yes
22Senior medical officer made aware of the patient with difficulty breathing, or shock (HR >100 or SBP <110) present at triage or oxygen saturation <95% within 5 min of initial assessment.10.01No
10.02No
23The clinician did assess airway patency by asking the patient a question and listening for a response.10.01No
10.02No
24.1Basic airway manoeuvre assistance (ie, sweep, chin lift, jaw thrust, oral or nasal airway, suction) performed for a patient with difficulty or obstructed breathing.10.01No
24.2Basic airway manoeuvre assistance (ie, jaw thrust, oral or nasal airway, suction, removal of foreign object) performed for a patient with difficulty or obstructed breathing.10.02Yes
25Examination for pneumothorax-haemothorax done by listening to both sides of the chest with a stethoscope within 5 min of patient arrival to emergency department.10.01Yes
10.02Yes
26Chest tube placed within 30 min of patient arrival in a patient with suspected or confirmed pneumothorax or haemothorax and oxygen saturation less than 98%.9.01No
10.02No
27.1Large-bore intravenous was placed within 5 min of patient arrival to the emergency department.10.01Yes
27.2Large-bore intravenous was placed within 5 min of patient arrival to the emergency department in patients with tachycardia (heart rate >110) or hypotension (systolic blood pressure <90).10.02Yes
28Pressure applied to external bleeding at patient arrival to the emergency department, and maintained until definitive control is performed.10.01No
10.02No
30.1Reduction and/or splinting with analgesia made for a long-bone fracture within 2 hours of admission or prior to transfer.10.01No
30.2Splinting with analgesia made for a long-bone fracture within 30 min of admission or prior to transfer.10.02Yes
35.1Burn patient did receive 2–4 mL of crystalloid solution per kilogram body weight per per cent body surface burn within 24 hours of injury.10.01No
35.2Burn patient did receive 4 mL of Ringer’s lactate per kilogram body weight per per cent body surface burn within 24 hours of injury.10.02Yes
36.1Senior attending physician alerted when airway is compromised, using jaw thrust, chin lift, oropharyngeal/nasopharyngeal airway or suction to open airway.10.01No
36.2Senior attending physician alerted within 5 min of patient arrival to the emergency department when airway is compromised, usage jaw thrust, chin lift, oropharyngeal/nasopharyngeal airway or suction to open airway.10.02Yes
37Assessment of mouth/throat for foreign bodies and debris made in a patient who has difficulty breathing, within 10 min of arrival to emergency department.10.01No
10.02No
38.1Breathing assessment made within 15 min of arrival to emergency department.10.01No
38.2Breathing assessment made within 5 min of arrival to emergency department.10.02Yes
40.1Patient assessed for hypovolaemia when presenting with hypotension and tachycardia or suspected intra-abdominal bleeding, femoral shaft fracture or pelvic fracture.10.01No
40.2Patient assessed for hypovolaemia using clinical examination, USG (Ultrasonography), FAST (Focused assessment with sonography in trauma) or DPL (Diagnostic peritoneal lavage) within 15 min of arrival to the emergency department when presenting with hypotension and tachycardia or suspected intra-abdominal bleeding, femoral shaft fracture or pelvic fracture.10.02Yes
45.1Laparotomy done within 1 hour of arrival to the emergency department in a patient with abdominal injuries and systolic blood pressure <90.5.51No
45.2Laparotomy done within 1 hour of arrival to the emergency department in a patient with abdominal injuries and systolic blood pressure <90 after fluid resuscitation.10.02Yes
46.1Immobilisation and imaging performed in a patient with suspected spine injury, within 4 hours of arrival to the emergency department.10.01No
46.2Immobilisation within 10 min and imaging performed within 4 hours of arrival to the emergency department in a patient with suspected spine injury.10.02Yes
47Intravenous antibiotics given within 1 hour of arrival to the emergency department in a patient with an open fracture.10.01No
10.02No
49.1Operation for irrigation and debridement within 12 hours from arrival to emergency department for an open fracture.10.01No
49.2Operation for irrigation and debridement within 6 hours from arrival to emergency department in a haemodynamically stable patient with an open fracture.10.02Yes
58.1Intubation performed in a patient with a GCS score of 8 or less within 30 min of arrival to emergency department.10.01No
58.2Intubation performed in a patient with a GCS score of 8 or less within 10 min of arrival to emergency department.10.02Yes
62Operation for subdural or epidural haematoma within 3 hours of arrival to emergency department.8.01No
9.02No
65FAST examination performed within 30 min from arrival to the emergency department to exclude haemoperitoneum.10.01No
9.02No
New66.1Antibiotics used in acute major (50% or more) burns within 24 hours.6.01NA
66.2Response time of respective department in attending the call.9.02NA
67.1MESS(Mangled extremity severity score) or WHO trauma scale used in prognosis mangled upper extremity.9.01NA
67.2Sample sent for investigations.8.02NA
68.1Facial 3D scan done to rule out facial fractures within 24 hours of arrival to the emergency department.5.01NA
68.2Airway breathing and circulation assessed immediately on arrival of a patient to the emergency department.10.02NA
69.1Serial assessment of vitals and GCS after admission.10.01NA
69.2Oxygen therapy with simple face mask initiated in a patient whose SpO2 is less than 92% within 5 min of initial assessment of the patient.10.02NA
70Response time in initiating definite treatment from arrival to the emergency department, by specialist department, within 1 hour from arrival to the emergency department.9.02NA
71Blood components started within 4 hours of arrival to the emergency department if the patient has an Hb <70 g/L.9.02NA
72AVPU(Alert, verbal, pain, unresponsive) for initial assessment and followed by sequential GCS.9.02NA
73Response time of surgeons.8.02NA
74Inotropes in a patient with shock.6.02NA
75Drug-assisted intubation.6.52NA
76Sample sent for blood group and cross-match in patients with significant bleeding (heart rate >110 or systolic blood pressure <90) within 15 min of arrival to the emergency department.10.02NA

  • *Original filter source group.

  • †Final median score.

  • ‡Indicates whether the filter was modified by the panellists.

  • GCS, Glasgow Coma Scale; HR, heart rate; LMIC, low and middle-income country; NA, not applicable; SBP, systolic blood pressure.