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Summer 2013

New blood refrigerator gives quicker access

New refrigerators for blood storage in the Emergency Department (ED) and Operating Room (OR) area make blood more accessible during emergency blood transfusions. The Trauma, ED, OR and Blood Bank teams implemented this new process in May in response to continued delays for red tag/O negative blood.

The new refrigerators store four to six units of O negative blood to be dispensed through the Omnicell.

“The staff will continue to draw a sample (T&C) of the patient’s blood to prepare type-specific blood for the patient at a later time. This new process will ensure timely transfusion of blood products to hemodynamically unstable patients. We are constantly looking for new ways to improve care for our trauma patients,” said Anissa Revels, RN, BSN, program manager.

Trauma team adds new members

The trauma team recently welcomed two new members:  Comprehensive Regional Pediatric Center Coordinator Tammie Alexander, RN, MSN, CRPC, and Angela Nobert, RN, BSN, who will serve as trauma coordinator.

Alexander comes to Le Bonheur from Arkansas Children’s Hospital where she worked as a Pediatric Intensive Care Unit nurse and as a PCM in the Emergency Department.  She played an instrumental role in obtaining that hospital’s ACS Level I Trauma status. She holds master’s degrees in nursing administration and nursing education from the University of Arkansas for Medical Sciences.

“Tammie will work with Le Bonheur staff to review data in order to determining gaps in care for patients who are transported in to Le Bonheur from outside facilities and accident scenes,” said Trauma Program Manager Anissa Revels, RN, BSN. “This information will be used to determine the needs for pediatric-focused education for the outlying hospitals and EMS service providers. We are honored to have Tammie on our team.”

Norbert joined the trauma team in March 2013 and has worked in the Emergency Department at Le Bonheur since 1987.

“Angela brings a wealth of knowledge and skills to this department from her tenure as an ED nurse,” Revels said. “She continues to learn and offer insight on ways we can make the department better.”

Multidisciplinary trauma rounds improve care, communication

The trauma department has started facilitating multidisciplinary trauma rounds on Monday mornings. The team has found that rounds help improve coordination of care for trauma patients and enhance communication among all members of a patient’s care team.

“We are able to discuss ongoing care of all of the trauma patients currently in house,” said Amie Yates, trauma coordinator. “This gives us a time to identify any specific needs of a patient and allows for all care providers to give input in order to provide the highest most effective level of care. This team has been very successful thus far in providing early intervention and treatment to our trauma patients.”

Study addresses management of blunt liver, splenic injuries

A study is now underway to examine the way blunt liver and splenic injury patients are treated. The prospective, observational study compares a decade-old guideline endorsed by the American Pediatric Surgical Association (APSA) to a more liberal guideline supported by some recent research findings.

Using the APSA guidelines, patients with blunt liver or splenic injuries are often admitted to the Pediatric Intensive Care Unit for 24 hours, transferred to another floor for several days and then discharged. Management decisions were dependent on the grade of organ injury as described by the radiologist and surgeons. 

New research data suggests objective clinical findings like normal hemodynamics and stability of the hemaglobin are better guides for management decisions.  These new guidelines, studied at Arkansas Children’s Hospital, decreased length of stay in the PICU and the hospital. 

The ATOMAC group, a research consortium that includes Arkansas Children’s, Dell Children’s Medical Center, Children’s Medical Center Dallas, the Children’s Hospital at OU Medical Center, Le Bonheur and Phoenix Children’s, believes the new guidelines will improve the quality of management of patients with solid organ injuries by shortening length of stay without impacting patient safety.
Copyright © 2013 Le Bonheur Children's Hospital, All rights reserved.

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