In situ trauma simulation training to improve time to computerized tomography among major trauma patients in an Emergency Department

Aim To investigate whether regular departmental, in situ simulation in trauma resuscitation improves time to computerized tomography (CT) in real patients presenting to the Emergency Department following major trauma. Methods Ten 30-minute in situ simulation sessions were conducted weekly over 10 weeks, involving Emergency Department staff members who typically form a trauma team. Each session included a 5-minute briefing, a 10-minute scenario and a 15-minute debriefing. Simulations were conducted using a combination of Laerdal MegaCode Kelly manikin with a SimPad Plus control device and iSimulate ALSi Patient Vitals iPad Software. The primary outcome measured was the time from the arrival of a patient into the Emergency Department resuscitation area to CT scan initiation. Results A total of 78 major trauma cases were included (40 pre-intervention and 38 post-intervention). Median time to CT decreased from 73 to 41 minutes – a 43.8% reduction (p = 0.033) – while the mean time decreased from 88 to 61 minutes. The proportion of patients receiving CT within 1 hour increased from 43% to 66% (p = 0.040). Although the proportion scanned within 30 minutes rose from 28% to 45%, this difference did not reach statistical significance (p = 0.262). The distribution of CT times shifted significantly towards earlier imaging post-intervention. Conclusions Regular in situ simulation training significantly reduces the time to CT for actual major trauma patients in the Emergency Department, enhances team performance and improves real-world clinical outcomes.