Are trauma surgeons prepared? A survey of trauma surgeons’ disaster preparedness before and during the COVID-19 pandemic

Trauma Surgery & Acute Care Open

article

Jay Doucet¹  David V Shatz²  Lewis J Kaplan³  Eileen M Bulger⁴  Jeannette Capella⁵  Deborah A Kuhls⁶  Mary Fallat⁷  Kyle N. Remick⁸  Christopher Newton⁹  Adam Fox^1,10  Randeep Jawa^1,11  John A Harvin^1,12  David P Blake^1,13  Marko Bukur^1,14  Jonathan Gates^1,15  James Ficke^1,16  Mark L Gestring^1,17 

[1] Department of Surgery , University of California San Diego Health System;Department of General Surgery , UC Davis Medical Center;Department of Surgery , University of Pennsylvania;Department of Surgery , University of Washington;Department of Surgery , The Iowa Clinic;Kirk Kerkorian School of Medicine , University of Nevada Las Vegas;Department of Surgery , University of Louisville;Department of Surgery , Uniformed Services University School of Medicine;UCSF Benioff Children's Hospital;Department of Surgery , Rutgers New Jersey Medical School;Department of Surgery , Stony Brook University;Department of Surgery , UT Health;Division of Acute Care Surgery , Inova Health System;Bellevue Hospital Center;Department of Surgery , Hartford Hospital;Department of Orthopedic Surgery , The Johns Hopkins University;1 Department of Surgery , University of California San Diego Health System , San Diego , California , USA 2 Department of General Surgery , UC Davis Medical Center , Sacramento , California , USA 3 Department of Surgery , University of Pennsylvania , Philadelphia , Pennsylvania , USA 4 Department of Surgery , University of Washington , Seattle , Washington , USA 5 Department of Surgery , The Iowa Clinic , Des Moines , Iowa , USA 6 Kirk Kerkorian School of Medicine , University of Nevada Las Vegas , Las Vegas , Nevada , USA 7 Department of Surgery , University of Louisville , Louisville , Kentucky , USA 8 Department of Surgery , Uniformed Services University School of Medicine , Bethesda , Maryland , USA 9 UCSF Benioff Children's Hospital , San Francisco , California , USA 10 Department of Surgery , Rutgers New Jersey Medical School , Newark , New Jersey , USA 11 Department of Surgery , Stony Brook University , Stony Brook , New York , USA 12 Department of Surgery , UT Health , Houston , Texas , USA 13 Division of Acute Care Surgery , Inova Health System , Falls Church , Virginia , USA 14 Bellevue Hospital Center , New York , New York , USA 15 Department of Surgery , Hartford Hospital , Hartford , Connecticut , USA 16 Department of Orthopedic Surgery , The Johns Hopkins University , Baltimore , Maryland , USA 17 Department of Surgery , University of Rochester

关键词: COVID-19;    Disasters;    Mass Casualty Incidents;   

DOI  :  10.1136/tsaco-2022-001073

学科分类：社会科学、人文和艺术（综合）

来源: BMJ Publishing Group

【 摘 要 】

Objective US trauma centers (TCs) must remain prepared for mass casualty incidents (MCIs). However, trauma surgeons may lack formal MCI training. The recent COVID-19 pandemic drove multiple patient surges, overloaded Emergency Medical Services (EMS) agencies, and stressed TCs. This survey assessed trauma surgeons’ MCI training, experience, and system and personal preparedness before the pandemic compared with the pandemic’s third year.Methods Survey invitations were emailed to all 1544 members of the American Association for the Surgery of Trauma in 2019, and then resent in 2022 to 1575 members with additional questions regarding the pandemic. Questions assessed practice type, TC characteristics, training, experience, beliefs about personal and hospital preparedness, likelihood of MCI scenarios, interventions desired from membership organizations, and pandemic experiences.Results The response rate was 16.7% in 2019 and 12% in 2022. In 2022, surgeons felt better prepared than their hospitals for pandemic care, mass shootings, and active shooters, but remained feeling less well prepared for cyberattack and hazardous material events, compared with 2019. Only 35% of the respondents had unintentional MCI response experience in 2019 or 2022, and even fewer had experience with intentional MCI. 78% had completed a Stop the Bleed (STB) course and 63% own an STB kit. 57% had engaged in family preparedness activities; less than 40% had a family action plan if they could not come home during an MCI. 100% of the respondents witnessed pandemic-related adverse events, including colleague and coworker illness, patient surges, and resource limitations, and 17% faced colleague or coworker death.Conclusions Trauma surgeons thought that they became better at pandemic care and rated themselves as better prepared than their hospitals for MCI care, which is an opportunity for them to take greater leadership roles. Opportunities remain to improve surgeons’ family and personal MCI preparedness. Surgeons’ most desired professional organization interventions include advocacy, national standards for TC preparedness, and online training.

【 授权许可】

CC BY-NC|CC BY|CC BY-NC-ND