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- W2565531384 abstract "Introduction: The hub and spoke model of trauma describes fracture stabilisation prior to referral. Many arrive at tertiary centres with inadequate temporary external fixation. This study investigates ex-fix availability, training and awareness of referral protocols in two regions. Methods: Hospitals feeding two regional trauma centres were targeted with two telephone questionnaires, one for on-call orthopaedic SpRs and one for theatre nursing staff ascertaining ex-fix availability, training, knowledge of regional referral protocols, and clinical scenarios to establish common practice in each unit. Results: 16 hospitals: 15 SpRs, 16 nurses responded Equipment: 0/31 aware guidelines for ex-fix stock - Ex-fix trays per unit (all manufacturers) mean = 4.14 (1–9) - Majority equipment in unit = Orthofix (11), Hoffman II (5), AO (1) - 12/15 SpRs reported insufficient ex-fix equipment for pelvis, 4 long bones and bridging knees (Damage Control Orthopaedics = DCO) - 7/15 SpRs reported insufficient ex-fix for 4 long bones/ bridging knees SpRs: - mean year of training = 2.2 - Experience: Generic trauma course (9) Specific ExFix (6) Manufacturer (9) - 14/15 would value specific regional ex-fix course - DCO patient scenario SpR unable to fix -lack of knowledge vs. lack of equipment 7/15 vs. 12/15 p Referral Protocols: - 7/31 aware of transfer protocol - 31/31 want referral routes clearly identified - 12/15 would value regular regional audit Discussion: A deficiency of ex-fix equipment for DCO/ polytrauma exists across many units in both regions. No accepted advice on equipment level requirement exists. All trainees had attended ex-fix teaching. Those who had only attended generic courses were less confident in DCO scenarios. Most favoured a specific regional ex-fix course. Tertiary care protocols have been distributed, but many units are unaware of their existence. A regular regional audit of trauma referrals would provide protocol reinforcement and opportunity for feedback." @default.
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- W2565531384 date "2008-08-01" @default.
- W2565531384 modified "2023-09-27" @default.
- W2565531384 title "TEMPORARY EXTERNAL FIXATION PRIOR TO TERTIARY REFERRAL: AVAILABILITY AND ABILITY." @default.
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