Evaluation of protocols for the initial management of severe maxillofacial trauma

[摘要] Introduction:due to its high incidence, maxillofacial trauma is one of the greatest challengesfor public health services. Protocols improve the quality of care and reducevariation in clinical practice, hence the crucial importance of high-qualityprotocolization in the area of trauma care. Objective:evaluate the care protocols followed in the emergency management of polytrauma,maxillofacial polytrauma and severe maxillofacial trauma. Methods:a descriptive cross-sectional qualitative study was conducted from May to June2015. An online search was carried out for protocols for the emergency managementof polytrauma, maxillofacial polytrauma and severe maxillofacial trauma in Spanish,English and Portuguese. A parallel national search was performed by telephoneand electronic mail. An evaluation tool was developed and an evaluation teamwas formed. Estimations were based on integers, indices and means. Results:the Protocol for Initial Management of Polytrauma scored 275 points, followedby Advanced Trauma Life Support with 229 (total difficulty index 0.93 and 0.70,respectively). The foreign maxillofacial protocol scored 150 points (total difficultyindex 0.46). Item 2 scored 128 points (total difficulty index 1). The protocolfrom Calixto García Hospital scored 223 points (total difficulty index0.73), and the ones from Matanzas and Villa Clara scored 120 each (total difficultyindex 0.32). Item 4 had the highest score, with 74 points (total difficultyindex 0.54). Conclusions:the highest quality foreign protocols were Initial Management of Polytraumaand Advanced Trauma Life Support, and the best developed item was number 2.The best national protocols were Management of Severe Trauma, from Calixto GarcíaHospital, and the ones from the provinces of Villa Clara and Matanzas. The bestdeveloped item was number 4.

[学科分类] 基础医学

[关键词] protocol;maxillofacial trauma;evaluation;polytrauma.