The NB Trauma Program not only has a mandate to increase research capacity, but is also actively engaged in conducting research. Here are some projects that the NBTP currently has on the go:
Outcomes in Older Adults with Isolated Hip Fractures: A Comprehensive Study across Regional Hospitals in New Brunswick
Hip fractures in seniors can have serious, sometimes fatal, consequences, even if they do not co-occur with other injuries (i.e., they are isolated). Given that the population of New Brunswick is aging, it is important to investigate the many factors that lead to varying outcomes for patients. To date, we are unaware of any study in New Brunswick that has examined clinical variability in hip fracture care and outcomes. A collaboration of both health authorities (Horizon Health Network and Vitalité), our research will examine if outcomes in persons age 65 and older with isolated hip fractures vary across regional hospitals that perform hip surgery in New Brunswick, and what that means for future clinical practice and policy changes.
Building a model for assessing trauma-related mortality in a rural trauma system
The present study investigates how to meaningfully communicate trauma mortality in a traditionally underrepresented rural setting, without compromising privacy nor losing relevant information for decision-making. In consultation with the Maritime SPOR SUPPORT Unit and the New Brunswick Institute for Research, Data and Training, we extracted all deaths from the NB Trauma Registry that occurred in the province’s two major trauma centres from 2011 – 2015. We calculated both age-specific and standardized death rates (ASMRs) to understand trauma-related mortality in New Brunswick, using the 2011 Canadian standard population, and used a three-year rolling time period to guard against year-over-year fluctuations. There were 941 trauma-related deaths that occurred in the two major trauma centres from 2011 to 2015. We found that adjusted age-specific death rates at both centres were relatively stable between the two time periods. Overall, the ASMR for the Level I Centre was 9.34 per 100,000 in 2011 – 2014, and 8.29 per 100,000 in 2012 – 2015. For the Level II Centre, these rates were 9.87 per 100,000 and 7.19 per 100,000, respectively. There were no significant differences in mortality odds ratios between the Level I and Level II Centres.
Does use of an RSI checklist and equipment silhouette in simulated emergency scenarios improve team performance and operational safety?
Rapid sequence induction (RSI) is a method to achieve airway control that involves rapid administration of sedative and paralytic agents, followed by endotracheal intubation. RSI is performed infrequently in New Brunswick, especially in rural settings. In addition, this procedure is difficult to perform, and is associated with numerous adverse outcomes such as hypoxia, hypotension arrhythmia, and death. This study evaluates two tools developed to improve RSI performance: (1) a checklist to promote adherence to a standard procedure and (2) an equipment silhouette to promote equipment preparation prior to RSI. To test the utility of these tools, simulated patients are used in trauma scenarios. Research using simulated patients is a humane way to assess an intervention’s effects without putting patients at risk. Simulated trauma scenarios are carried out in emergency departments throughout southern New Brunswick. Multidisciplinary teams, consisting of emergency physicians and nurses, perform RSI on simulated patients either with the aid of a checklist and equipment silhouette or without. Performance between these two groups will be compared, and the utility of these two tools will be inferred.
Research Supported by the NB Trauma Program
The NB Trauma Program provides an annual research grant (AIR) to a local research group investigating trauma, injury or related topics. Previous grant winners include:
2017/2018 AIR Award Winner: (TBD)
2016/2017 TPRF Award Winner: Dr. Neil Branch, Dr. Pamela Jarrett, Dr. James Wagg, Dr. Tushar Pishe, Ian Watson, Sue Benjamin, Dr. Linda Yetman, Dr. Bryn Robinson, Dr. Dan Crouse, Dr. Chris McGibbon & Allison Chisholm for the study: Outcomes in Older Adults with Isolated Hip Fractures: A Comprehensive Study across Regional Hospitals in New Brunswick
2015/2016 TPRF Award Winner: Dr. James French, Jacqueline Fraser & Devon McLean for the study: Does the use of an RSI checklist and equipment silhouette in simulated emergency scenarios improve team performance and operational safety?
2014/2015 TPRF Award Winner: Dr. Grant Hanigan, Dr. Gabriel Cormier, Dr. Mathieu Bélanger & Dr. Alier Marrero for the study: Validation of a novel tool, the RT2, for clinical diagnostic accuracy of falls occurrence in persons with Multiple Sclerosis
2013/2014 TPRF Award Winner: Dr. Paul Atkinson & Dr. James French for the study: Tranexamic acid for the treatment of significant traumatic brain injury: an international randomized, double blind placebo controlled trial.
2012/2013 TPRF Award Winner: Dr. Leanne Hewitson, Dr. Paul Atkinson, Dr. Glen Verheul & Dr. David Lewis for the study: ULTRASIM: Ultrasound in TRAuma SIMulation. Does ultrasound simulation improve diagnosis during simulated scenarios?
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