oa Integrated Trauma Anesthesia Service Pathway for Level I Trauma Center – Qatar Experience

Background: The Level 1 Trauma Center at Hamad General Hospital (HGH) offers world-class trauma services for Qatar, which also boasts the coveted Trauma Distinction Accreditation¹ award by Accreditation Canada. Consequently, HGH is expected to meet the Level 1 service specifications, which requires that an anesthetist should respond to Trauma 1 (T1) call within 15 minutes. Unfortunately, it was reported that this was not achieved in HGH, failing to fulfill the required compliance standard. In response to this, a new Trauma Anesthesia service was implemented, involving a pathway to deliver a 24/7 service by a designated team of Trauma Anesthetists taking part in all phases of trauma care (resuscitation, diagnosis, and treatment)^2,3 (Figure 1). This submission aims to describe the impact of this new service in providing timely care to trauma patients and thus meeting accreditation standards. Methods: This is a retrospective observational study primarily looking at the response time of the trauma anesthetists following a T1 call, which was recorded by the trauma nurses. Furthermore, the total number of trauma calls, proportional with T1 calls, and the number of trauma patients requiring anesthetic services were also collected. Data was collected from the Qatar Trauma Registry during the first six months (April to September 2020) of the new service. This data was then tabulated, analyzed, and expressed as a percentage (Table 1). Results/Findings: The study found that the service achieved a 100% (145) compliance rate for T1 anesthetic response time of 15 minutes. A total of 1029 trauma patients presented to HGH during the study period, of which 15% (145) were T1 admissions and about 10% (103) required surgical intervention. 25% (36) of T1 patients required anesthetic intervention. Conclusion: A 24/7 designated trauma anesthesia service provides high standards and continuity of care to trauma patients. The key anesthetic performance indicator for trauma accreditation was met.