Using clinical simulation to redefine and test new Trauma Care Guidelines

Back ground: The application of clinical practice guidelines (CPG) is crucially important to pre-hospital care practitioners. These are normally developed by clinical experts using an evidence-based approach whilst taking into account the scope of practice of the expected CPG users. Major trauma remains the most common cause of death making it very important to standardise the approach to these patients. Clinical simulation (CS) is the ideal platform to test and redefine CPGs before its release to the clinicians.

Methods: Emergency Response teams were created and was given an opportunity to review the new Trauma guideline. Each team then had an opportunity take part in two CS of which one was rural and the other one Urban setting to ensure its effectiveness and functionality. After the simulation participants completed a questionnaire (modified Technology Acceptance Model) and was part of a focus group discussion.

Results: The clinical simulation was perceived as useful and the CPG not easy to apply the scenario. Focus group feedback revealed that elements of the guideline required more clarification of misinterpreted elements around airway management, timing, fluid management, drug administration, colour coding of frames, arrows and management of poly-trauma cases.

Conclusions: The simulations and focus group discussions proved useful in identifying potentially confusing aspects of the updated CPG that may not have been noticed until actual implementation with real patients. It reinforced our belief that simulation should be further developed in the Service and exploited more regularly for training staff as well as for testing new protocols and systems.