David Wampler, PhD, LP, FAEMSDirector of Clinical Research

Office of the Medical Director – San Antonio Fire Department

&

Randi Schaefer, MSN, RN, CENResearch Director

Southwest Texas Regional Advisory Council

Regional Trauma Research:

Why Does it Matter

Preview

• Define “research”

• Types of research

• Who can do research

• Why should we do research

• Bedside Research

Definition of Research

• A systematic investigation into and study of materials, sources, etc. in order to establish facts and reach new conclusions

• An endeavor to discover new or collate old facts by scientific study of a subject or by a course of critical investigation

Definition of Research

• A systematic investigation into and study of materials, sources, etc. in order to establish facts and reach new conclusions

• An endeavor to discover new or collate old facts by scientific study of a subject or by a course of critical investigation

reSEARCH

Search for the truth

Types of Research• There can be many types based on

• Topic (clinical, behavioral, economic, etc.)

• Scope (case report, case series, etc.)

• Mode (observation, intervention)

• Methods (qualitative, quantitative)

• Utility (pure, applied)

• Technology (create new or apply existing) [field suction]

Does every question require systematic research?

Some Research can a lot of fun!!

Some Research can a lot of fun!!

Remote Trauma Outcomes Research Network

RemTORN

“What’s best for the patient?”

RemTORN

Goal: To develop and implement a research platform to study the impact of prehospital time, diagnostics, therapeutics on outcomes subsequent to injury in remote settings.

RemTORN• Collaborative project between:

• University Texas Health- San Antonio (UTHSA)

• Southwest Texas Regional Advisory Council (STRAC)

• Department of Defense (MRMC, JPC 6, CCRP)

• Civilian research model for translation to military prehospital care

• Identify and close research gaps in prehospital injury care

Tyranny of Time and Distance

Locations of TSA-P hospitals > 60 Miles from Level I Trauma Centers in San Antonio and Similarities in Scale to Iraq

Compensatory Reserve Index identified injured patients likely to deteriorate to shock, require blood transfusion, or procedural lifesaving intervention

Decision to Perform Lifesaving Interventions: The decision to perform a surgical cricothyrotomy was selected less often than expected regardless of TCCC training.

Results of RemTORN

Cervical Motion: Long Spine Boards do not

decrease cervical motion & 30 degrees head of bed elevated is best practice

Compensatory Reserve Monitoring GreenCardiovascular Reserve

Good

YellowCardiovascular Reserve

Poor

RedCardiovascular Reserve

Critical

Journal of Trauma and Acute Care Surgery 75 (2), S184-S189

Changing the Practice of EMS

Opportunities for Collaboration

• Access to prehospital and hospital data• 250,000 records added annually

• Topped 2.5 million records 2017

• Trauma registry software in all member hospitals

• Trauma, stroke, cardiac, emergency preparedness, disaster, special populations• Regional Trauma Registry – Military and Civilian Level I Trauma

• Cardiac – Stroke – Sepsis (future)

Future Studies

Future Studies

What is your day to day role in

research• Prehospital

• Documentation!!!• Data fields are more important than text boxes

• Extraction versus reading• #1 gap in prehospital research

• Think!!!! • What does not work in the back of an ambulance• What could work better

Questions???

Wamplerd@uthscsa.eduRandi.Schaefer@strac.org

mailto:Wamplerd@uthscsa.edumailto:Randi.Schaefer@strac.org

Please attend the scientific poster session

If you show up, Randi will buy you a drink!!!