1. Data Entry: System structure The Trauma Audit & Research Network (TARN) Data Collection session Log into:

2. Electronic Data Collecting & Reporting system (EDCR) overview
Process of care & outcome data relating to eligible Trauma patients
Secure on-line system (
Username & password required
Patient confidentiality paramount:
Names, Hospital Numbers, Full Postcodes not seen by TARN
Location based system, following patient pathway: From scene to Discharge
Choice of datasets: Core or Extended

3. Submission Contains all the data relating to a Patient’s incident:
Location
Outcome
Injuries

4. Submission Summary screen
Screen showing current STATUS of all your Hospitals’ submissions
You can access any submission by clicking on number adjacent to Status
You can see all submissions created by any User linked to your Hospital

5. Only Approved cases are used in Reports
Submission Status
CREATED
DISPATCHED
APPROVED
REJECTED*
RETURNED*
REDISPATCHED*
DISPATCHED & FLAGGED
AWAITING POST MORTEM**
Incomplete submission, data being entered
Complete submission, TARN to check
Checked & coded by TARN (part of Hospital dataset)
Does not fulfil inclusion criteria
Additional information requested by TARN
Additional information supplied by User
Flagged awaiting matching Transfer or PM
PM to be sent to TARN at later date
(reminder sent regularly)
Only Approved cases are used in Reports

6. Searching for submissions
Use any fields on SEARCH screen. FIND
Results appear at bottom of screen
Access relevant submission by clicking on (12 digit) Submission ID
Click REPORT to convert to Excel
Example: Hospital: St Elsewhere3
Admission Dates: 01/05/15-02/05/15
Status: All

7. Transfer notification system
TRANSFER NOTIFICATION: Submission Summary screen
Shows Missing transfers into/from your Hospital
Hover over Hospital name to show corresponding site coordinator details

8. The submission process
User:
Create New Submission:
Example: Hospital Holbya
NHS Number:
Date of Arrival: 10/01/2015
Time of Arrival: 10.00
Check for duplication
Unique Submission ID generated
Choose Dataset: Core or Extended
Enter & Save data
Validate data
Dispatch

9. Standard Screens
Core dataset
Extended dataset

10. Core Dataset Most fields Mandatory
For standard cases
Most fields Mandatory
Contains: ALL Fields used in routine analysis and reporting
Generic screens: Pre Hospital, ED, Critical Care
Limited Observations & Interventions

11. Requested: Pre Hospital, ED and Critical Care
Generic Questions
Requested: Pre Hospital, ED and Critical Care
Dates
Times
Observations (Patient’s observed status on arrival in location)

12. Requested: Pre Hospital, ED and Critical Care
Generic Questions
Requested: Pre Hospital, ED and Critical Care
Interventions (non surgical procedures given to patient in that location)
Attendants (Doctors who treated patient in that location)

13. Core Dataset: Observations & Interventions Pre-hospital, ED and Critical Care locations
Observations: 1st taken
Respiratory rate
Oxygen saturation
Blood pressure
Capillary refill
Pulse rate
Glasgow Coma Score*
Pupil reactivity**
Pupil size
Airway status
Breathing status
Interventions:
Airway support
Breathing support
Blood products in 24hrs
Tranexamic Acid
Chest drain
Spinal protection
Fluid
Extubation
Spinal Protection Removal
Embolisation

14. *GCS: Glasgow Coma Score: GCS
Measure of a patient’s level of consciousness, taken by assessing:
Eye, Verbal and Motor responses.
Ranges from 15 (normal functioning) to 3 (no responses).
Reduced GCS is an indication of a possible brain injury.
Used in the Probability of Survival model
Record: Pre Hospital, ED & at 1st hospital (Transfers in)
One of most important fields in EDCR: Part of the Data Accreditation %

15. Documentation of GCS & Intubation
Rapid Sequence Intubation (RSI) sometimes performed Pre Hospital
RSI: sedation & paralysis of a pt prior to Intubation
GCS3 often documented in ED: THIS SHOULD NOT BE RECORDED
Users should record in ED:
Airway Status: Intubated
Breathing Status: Ventilated
GCS: No
Resp Rate: No

16. **Pupil Reactivity Record: Pre Hospital, ED & Critical Care
Particularly important: When GCS is <15 or Head injury
Included in future Probability of Survival model
One of most important fields in EDCR: Part of the Data Accreditation %
Note: PEARL (Pupils Equal & Reacting to light) Record as BRISK

17. Specialist screens BOAST4 Rehabilitation prescriptions

18. Severe Open fractures of Tibia
BOAST 4
Guideline derived from BOA & BAPRAS
Severe Open fractures of Tibia
TARN specialist screen used to collect data
Guideline requires:
Early identification of severe open fractures of the tibia
Joint care from orthopaedic & plastic surgeons
Surgical wound debridement & operative fracture stabilisation within 24 hours
Definitive soft-tissue cover within 72 hours of injury

19. Severe Open Tibial fracture: Gustilo Anderson grade IIIB or IIIC
Gustilo Anderson Open fracture Classification
Severe Open Tibial fracture: Gustilo Anderson grade IIIB or IIIC

20. Specialist screen – BOAST 4
BOAST4 screen appears if User answers “Yes” to question on the Opening section:
“Does this patient have severe open lower limb fractures”?

21. BOAST4 “Did the fracture have surgical stabilisation” &
“Was definitive soft tissue cover of injury achieved”
Only answer YES if procedures performed at your Hospital.
BOAST4

22. Rehabilitation Prescription

23. Core Dataset: Outcome Measures screen
Note: This screen auto-populates post Injury Coding by TARN
Users do not enter data into this screen

24. Validating Click here to Dispatch to TARN VALIDATE
Missing Mandatory (red) & Preferred fields (green)
Mandatory fields must be corrected
Click here to Dispatch to TARN

25. View Diary*
Rejected submissions: Reason for rejection noted by TARN in Diary
Returned submissions: Additional information requested by TARN in Diary
Re-dispatched submissions: User should respond to TARN request in Diary & then Re-dispatch the submission

26. Awaiting Post Mortem**
Where selected: User should send Post Mortem to TARN when available
Particularly important: Deaths in ED
When sending PMs:
Annonymise
Include 12 digit submission ID
to: or
Post Mortems shredded by TARN after coding

27. Extended Dataset Complex cases Multiple ICU visits
Transfers in: bypass ED
Or ADDITIONAL data points e.g. Haematology, Blood Gases, Pelvic binder
All Observations, Interventions & Investigations shown
Core fields remain Mandatory
Extended dataset only fields: Not routinely analysed