Secondly, education should also focus on the benefits of TTL activation versus harm of “under-call”. Lastly, ongoing audits should target TTL activation rate

and timely feedback should be provided to all HDAC inhibitor players in trauma resuscitations to ensure proper and consistent TTL activation. Attrition of ATLS knowledge may also have contributed to poor compliance. In a study by Ali et al. [6], significant attrition rates of cognitive knowledge and skills was evident as early as 6 months after participants completed an ATLS course. The same group showed the attrition rate was higher for participants from low-volume Wnt inhibitor centers compared to high-volume centers [7]. To address this issue, continued trauma education for all members of the trauma team should be actively encouraged and supported. This can take the form of multidisciplinary trauma simulations, maintenance of ATLS certification, other advanced courses in trauma, and attendance at trauma conferences. Additional training in trauma team crisis resource management may improve team cohesiveness, and the requirement of all physicians involved in trauma resuscitations to maintain active ATLS certification should also be established. This Pitavastatin datasheet study has a number of limitations. Trauma resuscitations are highly dynamic and as such not all actions performed were adequately documented

with certainty. The chart review revealed a lack of time entries in many areas and this has made time-dependent outcome measures hard to gather. In particular, the rate of completion of FAST exams and time to FAST exam could not be reliably obtained from the chart review due to inconsistent record keeping. The study only reviewed data from a one-year period and as a result may not have the necessary power to show differences in major outcomes between the TTL compared to the non-TTL groups. However, we have obtained important data on the performance outcomes in the Interleukin-2 receptor form of ATLS compliance

rate, readmission rate, and indirect measure of efficiency of trauma resuscitations via times to diagnostic imaging. Additionally, we have also identified areas of future improvement with this quality assessment, and hope that other institutions will use our study as a model to promote their own quality reviews. Conclusions We have demonstrated that TTL involvement significantly improved compliance with many aspects of ATLS, and increased the efficiency of trauma resuscitations by decreasing mean time to diagnostic imaging. There is an acute need to improve compliance with ATLS protocols at our center as well as increase TTL involvement in major traumas at our institution. The reluctance in the hospital culture to activate the trauma team and TTL should be targeted with education around the importance of trauma team activation and involvement of TTL, as well as promotion of a culture of safety.