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IS IT NECESSARY TO CUT OFF CLOTHING AND PLACE A NASOGASTRIC TUBE AND FOLEY CATHETER IN ALL TRAUMA PATIENTS

  • Erol Armağan
  • Özlem Köksal
  • Halil İbrahim Çıkrıklar
  • Zülfi Engindeniz

Eurasian J Emerg Med 2003;2(1):27-29

According to advanced trauma life support (ATLS®) criteria, clothing should be cut off immediately for exposure, and a nasogastric tube and foley catheter placed during secondary survey of patients who require trauma team activation. Supertriage (secondary emergency room triage) criteria for trauma team activation are based on clinical and anatomic appearance, and requires major trauma team activation. In our study, patients not requiring major team activation according to supertriage criteria were retrospectively evaluated for the neccesity of NG tube and foley catheter placement, and the sharp removal of clothing.

Our tertiary-care university medical center emergency department received 240 trauma patients from August 2000 to August 2001 who were classified as major trauma according to mechanism of injury and coexisting conditions, but who did not meet major trauma criteria according to the physiological findings and anatomic injury classification of ATLS®, and who did not receive an NG tube and Foley catheter and whose clothing was not sharply removed. Of these 240 patients whose charts were reviewed retrospectively, 183 had no significant pathology and 41 were either admitted to the hospital or transferred for observation. No pathology was missed nor did any complications occur which might have been attributable to the non-performance of these interventions.

Patients not classified as major trauma according to anatomic and physiologic ATLS® criteria appear to not need routine sharp removal of clothing or NG tube and Foley catheter placement. Not performing these interventions may save time and decrease the need for trauma team activation. These findings need to be validated in a larger prospective study.