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Optimal Deployment of Trauma Personnel in the 80-Hour Work Week Era Based on Peak Times of Trauma Patient Arrival

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In the 80-hour work week era, optimal distribution of the residency workforce is critical. Little data exist as to whether current hours of hospital staffing parallel trends in trauma activity. The purpose of this study was to determine peak periods of trauma volume, severity, need for operative intervention, and mortality and determine if there are differences in mortality based on time period of arrival. We performed a retrospective analysis of the 17,167 patients admitted to our academic Level I trauma center between 2000 and 2007. Each admission was plotted against time of arrival and trends noted. A significant increase in activity occurred between 1700 and 0100 hours. Compared with other shifts, this shift had a disproportionately higher number of patients with penetrating injuries, need for operative intervention, Injury Severity Score (ISS) greater than 15, and death (P < 0.0001). After adjusting for ISS and penetrating trauma, arrival time was not predictive of mortality (OR 0.97, CI 0.87‐1.08, P = 0.6). In conclusion, a peak in trauma activity occurs during an evening shift between 1700 and 0100 hours. In an era of optimizing resident training within the constraints of an 80-hour work week, strong consideration should be made for deploying personnel to match these findings.
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Document Type: Research Article

Affiliations: Department of Surgery, Harbor-UCLA Medical Center, Torrance, California, USA

Publication date: October 1, 2010

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  • The Southeastern Surgical Congress owns and publishes The American Surgeon monthly. It is the official journal of the Congress and the Southern California Chapter of the American College of Surgeons, which all members receive each month. The journal brings up to date clinical advances in surgical knowledge in a popular reference format. In addition to publishing papers presented at the annual meetings of the associated organizations, the journal publishes selected unsolicited manuscripts. If you have a manuscript you'd like to see published in The American Surgeon select "Information for Authors" from the Related Information options below. A Copyright Release Form must accompany all manuscripts submitted.
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