Have patient pathways for penetrating chest injuries improved since designation as a London major trauma centre?

Results 25 cases from April, May and June 2010 (100% male, mean age 28.6 years) and 28 cases from April, May and June 2011 (100% male, mean age 24.1 years) were indentified. In 2010, mean time to CXR was 18.86 minutes, 95% CI (12.97, 24.75) and mean time to CT was 93.10 minutes (61.27, 124.93). In 40% of cases use of eFAST was documented. In total, 91.3% underwent CT scanning of the thorax. In February 2011, a Standard Operating Procedure (SOP) was introduced along with pre-registration of patients prior to arrival, use of a designated trauma CT scanner and increased training of eFAST. In 2011, mean time to CXR was 10.45 minutes, 95% CI (7.55, 13.35) and mean time to CT was 46.94 minutes, 95% CI (26.36, 67.52). In 54% of cases use of eFAST was documented. In total, 60.7% of cases underwent CT scanning of the thorax. Comparing this data over time, both time to CXR (p=0.012) and time to CT (p= 0.000024) have significantly decreased along with increased utilisation of eFAST and reduced use of CT scanning in accordance with the SOP.