Sandra Ware

Publications (2)2.17 Total impact

• Article: Helicopter emergency medical service registrars do not comprehensively document primary surveys.

  Sandra Ware, Cliff Reid, Brian J Burns, Karel Habig
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  ABSTRACT: OBJECTIVES: In-hospital primary surveys undertaken on traumatically injured patients can be inaccurate and incomplete. This study examined the documentation of prehospital primary surveys conducted by Greater Sydney Area Helicopter Emergency Medical Service registrars on trauma patients. METHODS: A retrospective case sheet review of prehospital trauma primary surveys documented by Greater Sydney Area Helicopter Emergency Medical Service registrars was carried out using previously published methodologies. A 13-item prehospital primary survey score was created and analysed by registrar specialty. A linear mixed model was used to determine whether differences in prehospital primary survey score existed between specialties. A one-point difference in the mean scores was considered clinically significant. RESULTS: A total of 75 charts were reviewed. An unadjusted mean of 9.5±1.6 (SD) items, out of a possible 13, was documented. Documentation was found to be less complete for anaesthetic trainees (adjusted mean score=9.10) than for emergency medicine trainees (adjusted mean score=10.34). The difference in the mean scores was 1.24 (95% confidence interval, 0.25-2.23, t53d.f.=2.52, P=0.01). A significant clustering effect was identified for individual registrars (χ1d.f.=6.03, P=0.01). A very good level of agreement was obtained between the PPSS raters (κ=0.93, 95% confidence interval, 0.87-0.99). CONCLUSION: Helicopter emergency medical service registrars do not comprehensively document prehospital primary surveys on traumatically injured patients. However, emergency medicine trainees document more completely than anaesthetic trainees. Individual registrar variation contributes significantly towards the completeness of prehospital primary survey documentation.
  European journal of emergency medicine: official journal of the European Society for Emergency Medicine 07/2012; · 0.73 Impact Factor
• Article: Improving documentation in prehospital rapid sequence intubation: investigating the use of a dedicated airway registry form.

  Roger Bloomer, Brian J Burns, Sandra Ware
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  ABSTRACT: OBJECTIVE: The quality of medical documentation is integral to audit, clinical governance, education, medico-legal aspects and continuity of patient care. This study aims to investigate the introduction of a dedicated 'Airway Registry Form' (ARF) on the quality of documentation in prehospital rapid sequence intubation. METHODS: A retrospective review and comparison of 96 cases predating the introduction of the ARF and 90 cases immediately following its introduction were performed. RESULTS: The introduction of the ARF yielded significant improvement in the recording of selected data points: difficult airway indicators (p<0.0001), Cormack-Lehane grade of laryngoscopy at first attempt (p<0.0001), documentation of confirmation of tracheal intubation with end-tidal carbon dioxide monitoring (p=0.015) and recording of intubator's details (p<0.0001). CONCLUSIONS: This study validates the use of a dedicated ARF for the improvement of documentation and data collection related to prehospital rapid sequence intubation when compared with post-event extraction of data from a generic case-record.
  Emergency Medicine Journal 04/2012; · 1.44 Impact Factor