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Who are the trauma team leaders across Canada? A national survey evaluating the profession in adult and pediatric level one trauma centres

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Canadian Journal of Emergency Medicine Aims and scope Submit manuscript

Abstract

Objectives

Trauma Team Leaders (TTLs) are critical for coordinating and leading trauma resuscitations. This survey sought to characterize the demographics and professional practices of Canadian TTLs at level one trauma centres. As a secondary objective, this information will be utilized to inform the operational goals of the Trauma Association of Canada (TAC) TTL Committee.

Methods

A detailed survey, developed by the TAC board of directors and TTL committee leads, was sent to 225 TTLs across Canada’s level one trauma centres. TTLs were identified via contacting trauma directors at each level one centre, in addition to public registry searches. This survey captured demographics, professional background, resuscitation practices, trauma team composition, and TTL involvement in trauma responses.

Results

The response rate was 41.7%. Mean respondent age was 42 (SD 7.4) and 71.0% were male. Most TTLs trained in emergency medicine (53.1%) or general surgery (25.5%); 63.8% underwent TTL training: either via a trauma surgery fellowship or TTL fellowship. All centres have a massive hemorrhage protocol implemented, and there is no large variation between the rates of use of cryoprecipitate and fibrinogen, nor the ratio of blood products transfused (2:1 vs 1:1). Most TTL respondents intend to participate in a TTL group associated with TAC (85.1%).

Conclusion

The results of this survey will contribute to the recognition of TTLs as a crucial role in the initial phase of care of severely injured trauma patients and serves as the first publication to document professional backgrounds and practices of Canadian TTLs at level one trauma centres. All the information gathered via this survey will be used by the TAC TTL Committee, which will focus on several initiatives such as the dissemination of best practice guidelines and creation of a TTL stream at the TAC Annual Conference.

Résumé

Objectifs

Les chefs d’équipe de traumatologie (TTL) sont essentiels pour coordonner et diriger les réanimations traumatiques. Cette enquête visait à caractériser la démographie et les pratiques professionnelles des TTL canadiens dans les centres de traumatologie de niveau 1. À titre d’objectif secondaire, cette information sera utilisée pour éclairer les objectifs opérationnels du Comité TTL de l’Association canadienne de traumatologie (ATC).

Méthodes

Un sondage détaillé, élaboré par le conseil d’administration de l’ATC et les responsables des comités de TTL, a été envoyé à 225 TTL dans les centres de traumatologie de niveau 1 du Canada. Les TTL ont été identifiés en contactant les directeurs de traumatologie de chaque centre de niveau 1, en plus des recherches dans le registre public. Cette enquête a porté sur la démographie, les antécédents professionnels, les pratiques de réanimation, la composition de l’équipe de traumatologie et la participation de la TTL aux réponses traumatologiques.

Résultats

Le taux de réponse était de 41,7 %. L’âge moyen des répondants était de 42 ans (ET 7,4) et 71,0 % étaient des hommes. La plupart des TTL ont suivi une formation en médecine d’urgence (53,1%) ou en chirurgie générale (25,5%); 63,8% ont suivi une formation TTL : soit via une bourse en chirurgie traumatologique ou une bourse TTL. Tous les centres ont mis en œuvre un protocole d’hémorragie massive, et il n’y a pas de grande variation entre les taux d’utilisation du cryoprécipité et du fibrinogène, ni entre le rapport des produits sanguins transfusés (2:1 vs 1:1). La plupart des répondants TTL ont l’intention de participer à un groupe TTL associé au TAC ( 85,1 %).

Conclusion

Les résultats de ce sondage contribueront à la reconnaissance des TTL comme un rôle crucial dans la phase initiale des soins aux patients ayant subi un traumatisme grave et serviront de première publication pour documenter les antécédents et les pratiques professionnelles des TTL canadiens au niveau un centres de traumatologie. Toutes les informations recueillies dans le cadre de cette enquête seront utilisées par le Comité TAC TTL, qui se concentrera sur plusieurs initiatives telles que la diffusion de lignes directrices sur les meilleures pratiques et la création d’un flux TTL à la conférence annuelle TAC.

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Funding

No financial support was received.

Author information

Author notes

  1. Isabella Menchetti and Madison Muzzo have contributed equally to this work as co-first authors.

Authors and Affiliations

  1. Department of Emergency Medicine, University of Ottawa, The Ottawa Hospital, Ottawa, ON, Canada

    Isabella Menchetti

  2. Department of Neuroscience, Northeastern University, Boston, MA, USA

    Madison Muzzo

  3. Department of Emergency Medicine, CHU de Québec-Université Laval, Quebec, QC, Canada

    Christian Malo

  4. Department of Emergency Medicine, St Michael’s Hospital, Toronto, ON, Canada

    Alun Ackery

  5. Department of Emergency Medicine, McGill University, Montreal, QC, Canada

    Joe Nemeth

  6. Department of Surgery, University of Saskatchewan, Regina, SK, Canada

    Jagadish Rao

  7. Department of Surgery, McMaster University, Hamilton, ON, Canada

    Paul T. Engels

  8. Department of Surgery, London Health Sciences Centre, London, ON, Canada

    Kelly Vogt

  9. Department of Surgery, McGill University, Montreal, QC, Canada

    Tarek Razek

  10. Department of General Surgery, St Michael’s Hospital, Toronto, ON, Canada

    Andrew Beckett

  11. Department of General Surgery, Sunnybrook Health Sciences Centre, Toronto, ON, Canada

    Luis da Luz

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  1. Isabella Menchetti
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  7. Paul T. Engels
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  8. Kelly Vogt
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  9. Tarek Razek
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  10. Andrew Beckett
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Contributions

LL and IM conceived and designed the survey. LL and IM led the collection of TTL contacts across Canada, and IM led the distribution of the survey to those contacts, supervised by LL. IM was responsible for collecting all data. IM and MM drafted the manuscript in equal proportions. LL was the primary content expert and contributed with substantive changes to the manuscript. All other authors contributed to the revision of the manuscript. All authors have seen and approved the final manuscript version. IM and MM equally take responsibility for the manuscript as a whole.

Corresponding author

Correspondence to Isabella Menchetti.

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Conflict of interest

All authors do not have any conflicts of interest to declare.

Additional information

Communicated by Andrew Petrosoniak.

Supplementary Information

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Supplementary file2 (PDF 366 KB)

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Menchetti, I., Muzzo, M., Malo, C. et al. Who are the trauma team leaders across Canada? A national survey evaluating the profession in adult and pediatric level one trauma centres. Can J Emerg Med 25, 959–967 (2023). https://doi.org/10.1007/s43678-023-00607-x

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  • DOI: https://doi.org/10.1007/s43678-023-00607-x

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