Trauma care? There's an app for that

In the hospital of the future, information can be blasted out in real time to the iPhones of trauma team members on their way to the ER. By the time doctors and nurses assemble, they won’t need to be brought up-to-speed because they will already know the patient’s history and vital signs.

A team of Los Angeles doctors has partnered with the U.S. military to make such improvements to emergency patient care, where seconds can mean the difference between life and death.

Fueled by a $4-million Department of Defense grant, the Cedars-Sinai hospital team developed an iPhone app to streamline information and improve communication. A text message feature allows them to coordinate and plan care while both they and the patient are en route to the ER. Saving precious seconds and even minutes of the “golden hour,”a military term for the most crucial time for a trauma patient, is the ultimate goal.

Using a new high-tech simulation lab, the doctors tested the app last week. While trainers observed from a monitor-filled “mission control”room, the LA team converged on the mock ER ready to treat a seriously injured car wreck victim in a realistic trauma simulation. The new app provided the fusion of information and communication needed to transformed chaos into choreography.

The iPhone app is just one step toward improving the speed and quality of trauma care. “The quicker we get patients cared for, the better the outcomes,”Surgeon-in-Chief Bruce L. Gewertz said in a statement.

Military experience has long guided trauma care. World War II introduced effective first-aid techniques and the use of antibiotics. Mobile Army surgical hospitals (MASH units) and helicopters were first used in the Korean War. The Vietnam War saw breakthroughs in the treatment of shock and chest injuries in the field. In the wars in Iraq and Afghanistan, hemostatic powders and dressings were developed to stop bleeding, and a more coordinated field trauma system emerged with forward surgical teams (FST) and combat support hospitals (CSH).

The Cedars-Sinai team visited military facilities around the world to interview experienced doctors and nurses. In addition to the iPhone app, those interviews prompted changes such as color-coded trauma bays with high-visibility whiteboards to display key patient information. Pre-briefings are now held in those bays before trauma patients arrive, allowing doctors, nurses, and others to understand their roles and ensure correct equipment and medications are ready.

“This is a new way to think about the improvement and delivery of healthcare,” said Ken Catchpole, director of Surgical Safety and Human Factors research at Cedars-Sinai. “It’s not just about new techniques or technologies or drugs, but how all those things work in unison.”