Structured Patient Path for Quality Assurance in Patients with Strangulation Trauma

Introduction A quality-oriented smart-hospital of the future requires a precise description of the various patient paths in algorithms. For the drowsy trauma, we have created a corresponding algorithm taking into account the current literature and a retrospective quality assurance analysis of our own patient cases.

Method Patient data from 10 patients as well as the literature recommendations according to the evidence-based-practice principle were evaluated. Both forensic aspects, such as consultative consultation with the forensic department for photographic documentation, as well as vascular surgery for the exclusion of a primary or secondary vessel dissection, as well as ENT-medical aspects such as the degree of mucosal bleeding or swelling including the vocal cord plane, are considered.

Results In case of clinical evidence of changes in the skin or mucous membranes of the ENT, at least 24 hours of in-patient monitoring are required to exclude secondary complications such as vascular dysplasia of the internal carotid artery, bleeding in the area of the deep cervical soft tissue (spatium praevertebrale), or fractures of the hyoid bone subsequent transfer of upper respiratory tract. The diagnosis must be secured by appropriate radiological slice imaging. Also in the after-treatment of such cases, there is a need for follow-up care, for example, with regard to a possible antibiotic or anticoagulative therapy.

Conclusion From this we developed a standardized patient path with definition of the chronology and priority order including the obligatory and optional interfaces for necessary consiliary co-examinations in the sense of an algorithm.

Poster-PDF A-1219.PDF

Publication History

Article published online:
10 June 2020